Tell me what’s really going on. The more detail you give me, the better I can understand your unique situation and provide thoughtful recommendations.

Take your time filling this out and be as detailed as possible. I personally review every submission and will get back to you within 24 hours.

This is not a cookie-cutter questionnaire with a one-size-fits-all answer. Your hormones, lifestyle, nutrition, symptoms, goals, and circumstances are unique to you—and your recommendations should be too.

The more you share, the more I can help.

Section 1: The Basics

Full Name *

Phone (Optional for SMS Reminders)

Email *

Instagram or FB Handle (So I can send your plan directly!)

Country of Residence (This helps me tailor your product recommendations and shipping options!) *

Current Life Stage: *

Perimenopause

Post-Menopause

I Have No Idea! Help!

Section 2: The "Messengers" (Symptoms)

What are your Top frustrations right now? (Check all that apply) *

On a scale of 1-10, how much is this affecting your daily confidence? *

Section 3: The "Terrain" (Current Routine)

Are you currently on BHRT or any hormone medications? (e.g., Estrogen, Testosterone, Progesterone, Thyroid meds) Please list ALL or write NONE if not applicable *

Are you using any GLP-1 support? (e.g., Ozempic, Wegovy, Mounjaro) List which one or NONE or Used to Be *

What supplements are you currently taking daily? (List everything (Brands etc) —let's see where we can simplify and save you money!) *

Do you have any known allergies or dietary restrictions? (e.g., Gluten-free, Dairy-free, Vegan, Medication etc...) *

Section 4: The Goal

If we could fix ONE thing in the next 90 days, what would it be?

Are you looking more for: 👉 1. Fitness + nutrition support (workouts, fat loss, structure, getting back on track)OR 👉 2. Hormone + body support (energy, bloating, cravings, sleep, skin, hair, feeling off)Most women actually need a mix of both — but I like to meet you where you’re at and not overwhelm you.Tell me which one feels more like you right now (or both), and I’ll guide you to the best place to start 💙

Are you ready to commit to a simple, 3-step daily foundation to see these results?

Yes!

I have questions first