Fill in the questionnaire, please.
The questionnaire serves for a right determination of an appropriate and efficient product combination,
the document is not being filed anywhere and is not to be used for any other purposes. Your enquiry will be processed
by STARLIFE Medical Council, then you will receive an e-mail (on the address you state below) with an appropriate answer.

* Please fill all fields marked in red color

Letters remaining:
Personal data
yes no
× daily
yes no
Body weight
yes no
Food composition
Physical activity
× daily
× weekly
yes no
yes no
Do you suffer from any of following problems?
A. Cell malnourishment stadium
B. Serious cell malnourishment stadium
C. Serious cell malnourishment stadium
D. Usage of medicaments for blood thinning, other medicaments or food supplements

Privacy statement

By filling in the form on the site, you are giving your personal information according to the law No. 101/2000 Coll., on personal data protection to company STARLIFE s.r.o., which operates

STARLIFE s.r.o. handles the personal data of the people that are registered through the website, as well as all data obtained from questioning or surveys, and that for an indefinite period, to the appeal of the consent of each registered person. STARLIFE s.r.o. hereby declares that all the information obtained be considered highly confidential and uses it only for their own use within the meaning of Act No. 101/2000 Coll. on the protection of personal data, to improve their services and for marketing purposes of the company STARLIFE s.r.o.

The person providing the information notes that its approval may at any time be writtenly revoked. Your personal information will not be disclosed to others without your consent. On the explicit request your personal information from the database of STARLIFE will be erased.

Please wait for data to load...