Health Assessment

Question 1 of 15

Let's start with your basic information

This helps us personalize your assessment and match you with the right specialist.

First Name *

Last Name *

Email Address *

Phone Number *

Date of Birth *

Gender *

Question 2 of 15

What is your primary health goal?

Select the option that best describes what you're looking to achieve.

Optimize Performance Enhance energy, focus, and physical capabilities

Extend Longevity Live longer and healthier with preventive care

Balance Hormones Address hormonal imbalances affecting wellbeing

Improve Fertility Optimize reproductive health

Metabolic Health Weight management and metabolic optimization

Question 3 of 15

How would you rate your current overall health?

Be honest - this helps us understand your starting point.

Excellent - I feel great and rarely have health issues

Good - I'm generally healthy with minor concerns

Fair - I have some health challenges I'm managing

Poor - I'm dealing with significant health issues

Question 4 of 15

Do you have any existing medical conditions?

Select all that apply. This information is confidential.

Diabetes or pre-diabetes

High blood pressure

Heart disease or cardiovascular issues

Thyroid disorder

Autoimmune condition

Anxiety or depression

None of the above

Question 5 of 15

Are you currently experiencing any of these symptoms?

Select all that apply. Some symptoms require immediate medical attention.

Chest pain or pressure

Difficulty breathing

Unexplained severe bleeding

Loss of consciousness or severe dizziness

None of these urgent symptoms

Immediate Medical Attention Needed

Based on your responses, you may be experiencing symptoms that require urgent medical care. Please seek immediate attention from an emergency room or call emergency services.

Emergency Resources

Call Emergency Services (911) Crisis Support Line (988)

If this was selected by mistake:

Assessment Complete!

Thank you for completing your health assessment. We're now matching you with the perfect specialist for your needs.

What happens next:

Create Your Account Set up secure access to your health dashboard
Doctor Assignment We'll match you with a specialist within 24 hours
Schedule Consultation Book your first appointment at your convenience