Energy — How often do you feel daytime fatigue or an afternoon crash? *
*
No Fatigue At All
A Little Fatigue
I Regularly Feel Fatigued
I Feel Fatigued 80% Of The Time
I Feel Extremely Fatigued All Day Every Day
Sleep (hours) — On most nights, how many hours do you sleep? *
*
7.5–9+ hrs
6.5–7.4 hrs
5.5–6.4 hrs
Less Than 5.5 hrs
Sleep (quality) — How often do you wake unrefreshed? *
*
I Feel Fully Refreshed When I Wake Up In The Morning
I Feel Slightly Tired When I Wake Up In The Morning Occasionally
I Feel Tired When I Wake Up Frequently But Not All The Time
I Feel Tired When I Wake Up In The Morning Most Days
I Feel Tired Every Day I Wake Up In The Morning
Cycles / ED (choose one path or N/A)**
*
Cycles regular, manageable
Cycles irregular or significant PMS/PMDD
Peri‑ or post‑menopause symptoms (hot flashes, night sweats, etc.)
Erection/sexual performance issues
Not applicable
About how often is sex drive or sexual performance an issue?**
*
I Never Experience Issues With My Sexual Drive Or Sexual Performance
Sex Drive and Performance is Rarely An Issue
I Frequently Experience Issues With Sex Drive And Sexual Performance
I Often Experience Issues With Sexual Performance And Sexual Drive
I Experience Issues With Sexual Performance And Sexual Drive Every Time I Am Intimate
Which best describes you right now?
*
Lean/toned (at goal)
Carrying ~5–15 lb extra
Carrying ~15–30 lb extra
Carrying 30+ lb extra
How many days/week of purposeful training (or ≥8k steps) do you average?
*
5–7
3–4
1–2
0
How often do you feel wired, anxious, or overwhelmed?
*
Never
Rarely
Sometimes
Often
Always
How often do you notice brain fog, focus or memory issues?
*
Never
Rarely
Sometimes
Often
Every Day
How often do low mood or irritability get in the way of your day?
*
Never
Rarely
Sometimes
Often
Every Day
Meds/Supps (select all that apply)
*
On thyroid medication
On hormone therapy (T/E/Progesterone)
On GLP‑1s (semaglutide/tirzepatide)
On SSRIs/SNRIs
On sleep meds
None of the above
Age Range (for context)
*
18–29
30–39
40–49
50–59
60+
First Name
*
Last Name
*
Phone
*
Email
*