Peptide Therapy Assessment

Answer a few questions to get personalized peptide therapy 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 9 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

Do you have any of the following medical conditions? *

Question 5

Which symptoms are you experiencing? *

Question 6

What are your primary health goals? *

Question 7

Do you experience any of these growth hormone related symptoms? *

Decreased muscle mass

Increased body fat, especially around the waist

Reduced bone density

Decreased energy levels

Poor exercise capacity

Elevated cholesterol levels

None of these

Question 8

What best describes your current weight management situation? *

Need to lose more than 30 pounds Need to lose 10-30 pounds Need to lose less than 10 pounds Want to maintain current weight Want to gain muscle mass

Question 9

Do you have any specific healing or recovery needs? *

Question 10

Which cognitive areas would you like to improve? *

Question 11

How would you rate your immune system health? *

Get sick frequently (more than 4 times per year) Get sick occasionally (2-3 times per year) Rarely get sick (once a year or less) Dealing with chronic infection Active autoimmune condition

Question 12

How would you describe your sleep quality? *

Severe insomnia (less than 4 hours per night) Moderate insomnia (4-6 hours per night) Light/interrupted sleep Adequate sleep (6-8 hours) Good quality sleep (7-9 hours)

Question 13

Have you used any peptides or hormone therapies before? *

No, never used peptides Yes, prescribed by a physician Yes, self-administered/research peptides Currently using peptide therapy

Question 14

Have you had recent blood work done? *

Question 15

Do you have any sexual health concerns?

Question 16

What are your longevity and anti-aging priorities?

Question 17

Describe your current lifestyle factors:

Regular exercise (3-5x/week)

Optimized diet (whole foods, adequate protein)

Good stress management

Good sleep quality (7-9 hours/night)

Currently taking supplements

Moderate alcohol consumption

Non-smoker

Question 18

What is your preferred method of peptide administration?

Question 19

What is your monthly budget for peptide therapy?

Question 20

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 21

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 22

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.

Create Your Account

We'll personalize your results and send them to you.

First Name *

Last Name *

Email Address *

Phone Number

For appointment scheduling (optional)

I agree to the Terms of Service and Privacy Policy

We'll email you a secure link to access your results anytime — no password needed.

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

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