Clone of Metabolic Reset Assessment

Metabolic Reset Pathway

These quick questions help us understand what brings you here and whether this reset may be a strong fit for you. Answer what you feel comfortable with.
Tell us about you
First and Last Name*
Best Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Time Zone*
Where did you hear about us?
If you selected ‘friend’ - Please specify their name.
Have you taken the Metabolic Dysfunction Quiz yet?
Your Vision + Your Why
Describe your perfect day in your healthiest, strongest, most confident body. Describe it to us like a movie*
What part of that picture are you missing most right now?*
What would change first for you or your family if you got that part back?*
Your Current Metabolic Symptoms
Which of these describe you right now?*

Fatigue or low energyDifficulty losing weightPoor digestion or bloatingMood swings or irritabilitySleep problemsSugar cravingsBrain fog or difficulty concentratingSlow metabolismHormonal imbalancesFrequent hunger or overeatingOther
On a scale 1-10, how out of sync does your metabolism feel?*

1

2

3

4

5

6

7

8

9

10

1 is Thriving, 10 is SOS
What have you tried so far to fix this?*

Diet changesExercise routinesSupplements or vitaminsDetox programsMedicationTherapies or coachingFad dietsNoneOther
Why do you think those things did not work long term?*
How is this struggle affecting your life right now?*

Reduced energy and motivationImpact on family relationshipsWork productivity declineMental health challengesPhysical discomfort or painSocial withdrawalFinancial stressOther
If nothing changes in next 6-12 months, what do you think happens?*
What results are you hoping for
What matters most to you right now?*

Improved energy and vitalityWeight loss and body compositionMental clarity and focusBetter sleep qualityEmotional balanceLong-term health and longevityOther
What support do you feel you need most to follow through?*

Accountability coachingPersonalized meal plansExercise guidanceMindset and motivation supportStress management techniquesCommunity supportOther
What current habits or patterns hold you back most?*
Are You Ready for a True Metabolic Reset?
If there was a proven path that burns fat, protects 98% of your lean mass, and reverses metabolic dysfunction, how open are you to following it exactly as designed?

Very open and committedSomewhat open, need more infoNot sure yetNot open at all
Are you prepared to invest time, energy, and money into your health if the plan fits you?

YesYes but need detailsNot right now
If accepted, how soon would you want to start?

Right awayThis weekWithin the next two weeks
16 Week Metabolic Reset Results
Anything else you want me to know before I review your application?
Should be Empty:

Metabolic Reset Pathway

Tell us about you

Your Vision + Your Why

Your Current Metabolic Symptoms

What results are you hoping for

Are You Ready for a True Metabolic Reset?

16 Week Metabolic Reset Results