How Well Is Your Body Really Doing

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Your full name* This field is required.
First Name
Last Name
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Your Email* This field is required.
example@example.com
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Question 1: How would you describe your energy levels on most days?* This field is required.
A. I feel exhausted no matter how much I sleep it's like running on empty
B. I have some good days, but I crash hard in the afternoons
C. I'm mostly okay but I wish I had more consistent energy
D. My energy is pretty good overall
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Question 2: When it comes to eating, what feels most true for you?* This field is required.
A. I eat pretty well butstill feel bloated, inflamed, or heavy it makes no sense
B. I know what I should eat, but I struggle with cravings or emotional eating
C. I eat whatever is convenient and haven't really focused on nutrition yet
D. I have a solid routine and feel good about how I eat
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Question 3: How has your sleep been lately?* This field is required.
A. I sleep but wake up feeling unrefreshed or I struggle to stay asleep
B. My sleep is inconsistent; some nights are fine, others are rough
C. I could sleep better but it's not something I've focused on
D. I sleep well and feel rested most mornings
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Question 4: How would you describe your stress level right now?* This field is required.
A. It's constant   I'm overwhelmed and my body feels the weight of it
B. It comes in waves and I don't always have great ways to manage it
C. Moderate  I'm managing but it affects my health more than I'd like
D. Fairly low  I have good tools and feel balanced most of the time
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Question 5: What does your movement or exercise routine look like?* This field is required.
A. I try to move but I'm either too tired or my body isn't responding the way it used to
B. I'm inconsistent I'll do great for a week and then fall off
C. I have a light routine but I know I could do more
D. I move regularly and feel good about my activity level
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Question 6: How does your digestion feel on a daily basis?* This field is required.
A. Bloating, gas, discomfort, or irregular digestion is almost constant for me
B. It varies I have flare-ups, especially when I eat certain things or when stressed
C. It's mostly okay but I know something feels off and I haven't figured it out
D. My digestion is generally fine and doesn't bother me
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Question 7: Have you noticed any of these in your body recently? (Choose the one that fits best)* This field is required.
Hot flashes, mood swings, stubborn belly fat, or joint pain that won't budge even with effort
One or two of those things, occasionally, like an off cycle or a random rough night
Minor shifts here and there, but nothing that's really affecting my daily life
None of the above, I feel pretty good physically
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Question 8: Have you tried diets, cleanses, or wellness programs before?* This field is required.
A. Yes multiple times, and nothing has ever felt sustainable or personalized tome
B. Yes, I've tried a few things. Some helped short term but nothing lasted
C. I've tried one or two things casually but never committed fully
D. Not really I'm fairly new to focusing on my health intentionally
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Question 9: When you think about your health goals, which feels most true right now?* This field is required.
A. I am done guessing. I want to understand my body and have a real plan that works for me
B. I'm ready to make changes but I'm not sure where to start or what will actually work
C. I'm interested but still exploring I haven't fully committed to anything yet
D. I'm mostly curious right now and not in a rush to make changes
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Question 10: How do you feel about investing in your health right now?* This field is required.
A. I'm absolutely willing to invest if I believe it will actually work for my body specifically
B. I'm open to it but would want to start withsomething smaller before committing fully
C. Budget is a concern but health is becoming apriority I'm thinking about it
D. I'm not ready to invest financially in thisarea right now
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