Lab Recommendations Name * First Name Last Name Age * Email * (your recommendations will be sent here) Top 3-5 health concerns * Top 3-5 health goals? * Current and past diagnoses? * What symptoms are you currently experiencing? * Current medications? * Any allergies or adverse reactions to any supplements or medications? * How is your sleep? Any issues falling or staying asleep? * How is your digestion? Do you experience any bloating, cramping, reflux, constipation, or diarrhea? * Are you experiencing any hormonal changes like PMS, hot flashes, changes in libido, or abnormal cycles? * How are your stress levels on a scale of 1-10? * How is your diet? Excellent, fair, or poor? * On average, how much water do you drink per day? * Approximately how many alcoholic beverages do you consume per week? * How many days do you exercise per week? Do you lift weights? * Do you have any children? If so, how many and what are their ages? * What is your current relationship status? * Thank you for submitting our questionnaire! Our team is currently reviewing your responses and you can expect to receive our recommendations within 1-2 business days.
