First Name * Age Do you have consistent energy throughout the day? * Yes No Do you typically need caffeine to get through your day? * Yes No Do you have trouble falling asleep/staying asleep throughout the night? * Yes No Do you experience brain fog or have trouble concentrating? * Yes No Are you having bowel movements every day? * Yes No Do you experience headaches and migraines regularily? * Yes No Are your hands, feet, and nose sensitive to cold? * Yes No Have you noticed you hair thinning or falling out? * Yes No In the last 2-3 years has your weight remained stable? * Yes No Do you get hangry often (once a week or more)? * Yes No Are your period cycles consistently 24-35 days? * Yes No Do you experience symptomatic periods (cramping, heavy bleeding, breast tenderness, PMS or mood swings)? * Yes No Do you struggle with acne or other skin conditions? * Yes No Do you handle stress well? * Yes No Do you have constant sugar or salt cravings? * Yes No Email * Thank you, your results should be in your inbox in the next few minutes!