What is your number 1 health goal?

More energy & focus

Lose weight/reduce cravings

Better digestion/gut health

Aging well

I’m not sure, I just want to feel better

What’s your biggest daily struggle?

Bloating or digestive discomfort

Cravings or late-night snacking

Getting sick more often than I’d like

Brain fog or poor focus

Poor sleep or trouble recovering

 Which digestion symptoms do you experience?

Bloating

Gas

Constipation

Food sensitivities

None of the above

How would you rate your energy levels most days?

• Very Low
• Low
• Moderate
• Good
• Excellent
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How would you rate your sleep quality?

• Very Poor
• Poor
• Okay
• Good
• Excellent
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Do you currently take supplements?

• Yes
• Maybe later
• No
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Which best describes you?

• Busy professional
• Parent
• Athlete
• 35+ focused on longevity
• Other
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