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Question 1/7
Primary Goal
What is your primary goal?
Weight Loss
How much weight are you looking to lose?
5-10lbs
10-20lbs
20-40lbs
40lbs+
Performance
Recovery
Longevity
Vitality+ (Hair, Sexual Wellness, or Cognition)
Secondary Goals
What else would you like to improve?
Energy
Sleep
Fat loss
Muscle growth
Recovery time
Skin / appearance
Hormone balance
Focus
Stress
Symptoms
Are you experiencing any of the following?
Hard to lose weight
Fatigue
Low libido
Poor recovery
Brain fog
Poor sleep
Increased body fat
Hair thinning
None
Metabolic Indicators
Do any of these apply?
Appetite control issues
Blood sugar issues / cravings
Weight gain despite effort
None
Hormone Optimization Permission
Would you like to explore hormone optimization if appropriate?
Yes
Maybe
No
Experience Level
Have you used peptides or hormone therapy before?
No, I'm New
Peptides only
Hormones only
Both
Protocol Style
How would you like your plan structured?
Let you choose what’s best for me
Keep it simple (2–3 therapies)
More optimized (3–4 therapies)
Full optimization (4–5 therapies)
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