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Hey, we'd love to get to know you better. Please share your current health state.

Poor
Could be better
Average
Pretty good
Feeling great

Many factors can impact your well-being, but feeling full of crap is at the top of the list. Are you prone to:

Bloating
Weight-gain
Constipation
Diarrhea
Mood swings
Brain fog
Overeating
None

It's time to get personal. Did you know that your stool can say a lot about your health? Let us know how often you poop:

Everyday
Twice a week
Once a week
Less than once a week

It all starts from within – your gut health is responsible for more than just your pooping schedule. Do you experience any of these symptoms?

Skin issues (acne, eczema, rashes)
Blood sugar fluctuations
Heartburn
Hunger after meals
Sugar and carbohydrate cravings
Stomach pain and cramps
Fatigue
Moodswings
None
Prefer not to say

Constipation, bloating, and excess gas are not the only signs that your gut is having a tough time. Have you ever experienced the following?

Difficulty or pain passing bowel movements
Oral Infection
Mood disorders
Digestion issues
Stomach cramping
Nausea
Increased appetite
Joint pain
None
Prefer not to say

To ensure ColonBroom is safe for you to use, please let us know if you have any of the following sensitivities or allergies:

Wheat and gluten
Lactose
Nuts
Fish
Seafood
Citrus fruits
Strawberries
None
Other

You're doing amazing! To guarantee you have the best experience using ColonBroom, let us know if you have any of the following medical conditions:

High cholesterol and/or blood triglycerides levels
Thyroid issues
Gout
Diabetes
None
Other
Prefer not to say

Do you have/have you had the following diseases of the digestive system?

Gastritis
Irritable bowel syndrome (IBS)
Gastroesophageal reflux disease (GERD)
Diverticulitis
Colitis
Crohn’s disease
None
Other
Prefer not to say

Engaging in physical activity can impact how often you poop. How active are you?

Sedentary
Very light
Light
Moderate
Active
Very active

How much of your free time do you spend doing something active every day (yes, walking down to the bathroom several times per day also counts)?

Very little
15 - 30 minutes
30 - 60 minutes
60 - 90 minutes
90+ minutes

Enter your age

years

Enter your height

ft
in

Enter your weight goals

lb
lb

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