Health Assessment

Answer a few questions to evaluate your overall health and get personalized recommendations.

What You'll Get:

✓
Five-Engine Health Score Comprehensive evaluation across five health dimensions
✓
Personalized Recommendations Tailored treatment options based on your results
✓
Real-Time Insights See your health baseline as you complete the assessment

About 14 minutes to complete

HIPAA-compliant & secure

Question 1

What is your gender? *

FEMALE MALE

Question 2

What is your date of birth? *

Month

Day

Year

Question 3

What is your height and weight? *

Height

ft

in

Weight

lbs

Question 4

How would you rate your current overall health? *

Excellent - I feel great and have no health concerns Good - I feel generally healthy with minor issues Fair - I have some health concerns that affect me Poor - I have significant health issues Very Poor - I have serious health problems

Question 5

How are your energy levels throughout the day? *

High and consistent throughout the day Moderate and consistent High in morning, lower in afternoon Good in morning, crash in afternoon Consistently low throughout the day

Question 6

How would you rate your daily physical function and mobility? *

Excellent - I move freely without any limitations Good - Minor stiffness but no real limitations Moderate - Some activities are challenging Limited - Daily tasks are often difficult Severely Limited - I need assistance with basic activities

Question 7

How would you describe your digestive health? *

Excellent - Regular, comfortable digestion Good - Occasional minor discomfort Moderate - Frequent bloating or irregularity Poor - Chronic digestive issues affecting quality of life Severe - Significant digestive problems requiring management

Question 8

How would you rate your cardiovascular and respiratory health? *

Excellent - Strong endurance, never short of breath Good - Comfortable with moderate activity Moderate - Short of breath with extended activity Poor - Easily winded with minimal exertion Very Poor - Difficulty breathing at rest or with any activity

Question 9

How stable has your weight been over the past year? *

Very stable - Within 5 lbs of my target Stable - Minor fluctuations (5-10 lbs) Moderate fluctuations (10-20 lbs) Significant changes (20+ lbs) - Unintentional Actively working on weight management

Question 10

How often do you get sick (colds, infections, etc.)? *

Rarely - Less than once a year Occasionally - 1-2 times a year Moderately - 3-4 times a year Frequently - Every few months Very often - Monthly or more

Question 11

Do you have any diagnosed chronic health conditions? *

No chronic conditions One condition, well-controlled Multiple conditions, well-controlled One condition that is challenging to manage Multiple conditions, some challenging to manage

Question 12

How many days per week do you engage in moderate to vigorous exercise? *

Question 13

How would you describe your typical diet? *

Primarily whole foods, rich in fruits and vegetables Generally balanced with some processed foods Mixed - some healthy, some processed foods High in processed foods and sugar Irregular or often skip meals

Question 14

How much water do you typically drink each day? *

8+ glasses (64+ oz) - Well hydrated 6-8 glasses (48-64 oz) - Adequately hydrated 4-6 glasses (32-48 oz) - Could be better 2-4 glasses (16-32 oz) - Often dehydrated Less than 2 glasses - Rarely drink water

Question 15

How would you rate your mental health and emotional well-being? *

Excellent - I feel mentally strong and emotionally stable Good - Generally positive mood with minor fluctuations Moderate - Some mood swings but manageable Poor - Frequent mood issues affecting daily life Very Poor - Significant mental health struggles

Question 16

How would you describe your stress levels? *

Very Low - I rarely feel stressed Low - I experience minimal stress Moderate - I experience some stress but manage it well High - I frequently feel stressed and overwhelmed Very High - I feel constantly stressed and struggle to cope

Question 17

When facing setbacks or challenges, how do you typically respond? *

Very resilient - I bounce back quickly and learn from adversity Resilient - I recover well, though it takes some time Moderate - I manage eventually, but struggle initially Struggling - Setbacks significantly affect me for extended periods Overwhelmed - I find it very difficult to cope with challenges

Question 18

How would you describe your sleep quality? *

Excellent - Deep, restorative sleep every night Good - Generally restful sleep most nights Moderate - Some sleep issues but mostly restful Poor - Frequent sleep problems affecting daily life Very Poor - Severe sleep issues

Question 19

On average, how many hours of sleep do you get per night? *

7-9 hours - Optimal sleep duration 6-7 hours - Slightly below optimal 5-6 hours - Short sleep 4-5 hours - Very short sleep Less than 4 hours or more than 10 hours

Question 20

How consistent is your sleep schedule (bedtime and wake time)? *

Very consistent - Same time within 30 minutes daily Consistent - Same time within 1 hour most days Moderately consistent - Varies 1-2 hours Inconsistent - Varies significantly (2+ hours) Erratic - No regular sleep schedule

Question 21

How do you typically feel when you wake up in the morning? *

Refreshed and energized - Ready to start the day Rested - Need a few minutes but feel good Groggy - Takes 30+ minutes to feel alert Tired - Don't feel rested despite sleeping Exhausted - Feel like I haven't slept at all

Question 22

How long does it typically take you to fall asleep? *

Under 15 minutes - Fall asleep quickly 15-30 minutes - Normal sleep onset 30-60 minutes - Delayed sleep onset 1-2 hours - Significant difficulty falling asleep Over 2 hours - Severe insomnia symptoms

Question 23

How would you describe your social connections and relationships? *

Excellent - Strong, supportive relationships Good - Generally positive relationships Moderate - Some good relationships, some challenges Poor - Limited or strained relationships Very Poor - Isolated or toxic relationships

Question 24

How would you describe your ability to focus and concentrate? *

Excellent - No issues with focus or concentration Good - Minor focus issues, easily managed Moderate - Some difficulty concentrating at times Poor - Significant focus problems affecting work/life Very Poor - Severe concentration issues

Question 25

How would you describe your overall mood? *

Very Positive - Optimistic and happy most of the time Positive - Generally good mood with occasional lows Neutral - Stable mood, neither particularly high nor low Negative - Often feeling down or irritable Very Negative - Frequently depressed or anxious

Question 26

How would you describe your motivation and drive? *

Very High - Highly motivated and driven High - Generally motivated with clear goals Moderate - Some motivation but could be stronger Low - Often struggle with motivation Very Low - Frequently lack motivation and drive

Question 27

How would you describe your overall life satisfaction? *

Very Satisfied - I am very happy with my life Satisfied - I am generally happy with my life Neutral - I am neither particularly satisfied nor dissatisfied Dissatisfied - I am often unhappy with my life Very Dissatisfied - I am very unhappy with my life

Question 28

Would you be interested in hormone testing to optimize your health? *

Very interested - I want comprehensive hormone testing Interested - I would like to learn more first Curious - Maybe, if recommended Not now - I'll consider it later No interest at this time

Question 29

Which substances do you regularly use? (Select all that apply)

None of these

Caffeine (1-2 cups coffee/tea daily)

Caffeine (3+ cups daily)

Alcohol (1-2 drinks per week)

Alcohol (3+ drinks per week)

Tobacco or nicotine products

Cannabis (medical or recreational)

Question 30

Are you experiencing any of these hormone-related symptoms? (Select all that apply)

Question 31

Select any symptoms you are currently experiencing:

Question 32

For women: How would you describe your menstrual cycle or menopausal status?

Regular cycles - Predictable and normal Irregular cycles - Unpredictable timing or flow Perimenopausal - Transitioning (irregular periods, symptoms) Postmenopausal - No periods for 12+ months Not applicable / Prefer not to answer

Question 33

Enhance Results with Visual Analysis (Optional)

Enhance Results with Visual Analysis (Optional) Upload a photo for AI-powered visual health analysis

HIPAA Protected Medical Images

Your medical photos are encrypted, stored securely, and protected under HIPAA. Images are analyzed by AI and immediately encrypted—they are never stored unprotected or shared with third parties.

No problem! You can skip this step and add photos later from your dashboard.

Question 34

Enhance Results with Your Location (Optional)

Enhance Results with Your Location (Optional) Enable precise location for enhanced results

HIPAA Protected

Your location data is protected under HIPAA and used only to provide locally-relevant health insights. We never share your precise location with third parties.

Enable to share your precise location

Question 35

Add lab results (optional)

Add lab results (optional) Optional: attach a lab PDF to enrich your assessment

HIPAA Protected & Encrypted

Your lab results are encrypted with AES-256 and protected under HIPAA. Only authorized healthcare providers can access your data. Your PDF is processed securely and never stored unencrypted.

No problem! You can skip this step and add lab results later from your dashboard.

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First Name *

Last Name *

Email Address *

Phone Number

For appointment scheduling (optional)

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After you submit, you'll see your results immediately.

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