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What is your primary wellness goal right now?

Longevity & Anti-Aging Energy & Focus Sleep & Stress Digestion & Gut Balance Immune System & Recovery Beauty: Skin, Hair & Nails

How would you describe your daily energy level?

How often do you feel exhausted in the afternoon?

How hard is it for you to fall asleep?

How often do you wake up during the night?

How regular is your digestion?

How often do you experience bloating or fullness?

How often do you get sick per year?

How quickly do you recover after physical or mental strain?

How satisfied are you with your skin?

Does your skin tend to feel dry or dull?

How important is long-term health to you?

Do you feel signs of oxidative stress?

How easy is it for you to stay focused for extended periods?

Do you often experience brain fog or mental fatigue?

How active are you during the day?

How would you rate your nutrition?

Do you feel tired or sleepy after meals?

How often do you experience mood swings or irritability?

How would you rate your current stress level?

How refreshed do you feel when waking up?

How rested do you feel in the morning?

How often do you feel emotionally drained?

How strong are inner restlessness or nervousness?

How quickly does your body react physically to stress?

How well can you wind down in the evening?

Do you use screens regularly before bedtime?

How consistent is your sleep schedule?

Do you feel constantly on edge or wired?

Do you often feel heavy or unwell after meals?

How sensitive is your stomach to stress?

How often do you feel you don’t tolerate certain foods well?

How many servings of fruits/vegetables do you eat daily?

How often do you consume fiber-rich foods?

Have you taken antibiotics in the last 12 months?

How often do you struggle with an unsettled stomach?

Do digestive issues limit your overall energy?

Do you often feel low-energy?

How would you rate the connection between your sleep and recovery?

How much natural sunlight do you typically get per day?

How high is your stress level?

Do you feel more vulnerable to illness during winter months?

How balanced is your diet?

How often do you feel inflammatory discomfort (joints, fatigue, etc.)?

How good are your daily movement and fresh-air exposure?

How firm does your skin feel?

How would you describe your daily energy level?

Very good, consistent all day Stable with minor dips Rather low, often tired Very low, exhausted most of the day

Are you currently experiencing increased hair fall?

How often do you feel exhausted in the afternoon?

Never Rarely Several times per week Daily

How would you rate your hair density?

How hard is it for you to fall asleep?

Very easy Occasionally difficult Often difficult Very difficult

How strong and stable are your nails?

How often do you wake up during the night?

Never Once in a while Several nights per week Almost every night

How stressed do you feel on a regular basis?

How regular is your digestion?

Very regular Mostly regular Irregular Very irregular

Is your diet rich in vitamins and minerals?

How often do you experience bloating or fullness?

Never Occasionally Frequently Almost daily

Do you drink enough water daily?

How often do you get sick per year?

Rarely / never 1–2 times 3–4 times 5+

How satisfied are you with your overall physical appearance?

How quickly do you recover after physical or mental strain?

Very quickly Fairly quickly Slowly Very slowly

How well do you recover after demanding days?

How satisfied are you with your skin?

Very satisfied Satisfied Somewhat dissatisfied Very dissatisfied

How nutrient-dense is your daily diet (vitamins & antioxidants)?

Does your skin tend to feel dry or dull?

Never Rarely Occasionally Often

How often do you feel tired even after sleeping?

How important is long-term health to you?

Extremely important Important Somewhat important Not a priority

How consciously do you manage lifestyle factors (alcohol, stress, sleep)?

Do you feel signs of oxidative stress?

No Mild Moderate Strong

What is your primary wellness goal right now?

How easy is it for you to stay focused for extended periods?

Very easy Mostly easy Somewhat difficult Very difficult

Do you often experience brain fog or mental fatigue?

Never Rarely Occasionally Yes, frequently

How active are you during the day?

Very active Regularly active Moderately active Not active

How would you rate your nutrition?

Very healthy & balanced Mostly balanced Mixed / inconsistent Unbalanced

Do you feel tired or sleepy after meals?

Never Rarely Sometimes Yes, often

How often do you experience mood swings or irritability?

Never Rarely Occasionally Often

How would you rate your current stress level?

Low Moderate High Very high

How refreshed do you feel when waking up?

Very refreshed Usually refreshed Somewhat tired Not refreshed at all

How rested do you feel in the morning?

Fully rested Mostly rested Somewhat tired Very tired

How often do you feel emotionally drained?

Never Rarely Often Constantly

How strong are inner restlessness or nervousness?

Not present Mild Moderate Strong

How quickly does your body react physically to stress?

Hardly at all Mild reaction Strong reaction Immediate & intense

How well can you wind down in the evening?

Very well Mostly well With difficulty Almost not at all

Do you use screens regularly before bedtime?

Never Occasionally Most evenings Every night

How consistent is your sleep schedule?

Very consistent Mostly consistent Irregular Very irregular

Do you feel constantly on edge or wired?

Never Rarely Often Almost constantly

Do you often feel heavy or unwell after meals?

Never Rarely Often Almost always

How sensitive is your stomach to stress?

Not sensitive Mildly sensitive Clearly sensitive Extremely sensitive

How often do you feel you don’t tolerate certain foods well?

Never Rarely Often Very often

How many servings of fruits/vegetables do you eat daily?

5+ servings 3–4 1–2 Almost none

How often do you consume fiber-rich foods?

Daily Several times/week Rarely Almost never

Have you taken antibiotics in the last 12 months?

No Once Twice Multiple times

How often do you struggle with an unsettled stomach?

Never Rarely Often Very often

Do digestive issues limit your overall energy?

Not at all Slightly Moderately Strongly

Do you often feel low-energy?

Never Rarely Often Almost always

How would you rate the connection between your sleep and recovery?

Very strong Mostly good Weak Very poor

How much natural sunlight do you typically get per day?

> 60 min 30–60 min < 30 min Almost none

How high is your stress level?

Low Moderate High Very high

Do you feel more vulnerable to illness during winter months?

No Slightly Clearly Very much

How balanced is your diet?

Very balanced Mostly balanced Inconsistent Poor

How often do you feel inflammatory discomfort (joints, fatigue, etc.)?

Never Occasionally Often Frequently

How good are your daily movement and fresh-air exposure?

Very good Good Limited Very little

How firm does your skin feel?

Very firm Mostly firm Less firm Noticeably less firm

Are you currently experiencing increased hair fall?

No Slightly Moderately Strongly

How would you rate your hair density?

Very good Good Thinner than before Very thin

How strong and stable are your nails?

Very strong Mostly strong Often brittle Very brittle

How stressed do you feel on a regular basis?

Low Moderate High Very high

Is your diet rich in vitamins and minerals?

Yes, very Mostly Not consistently No, rarely

Do you drink enough water daily?

Yes Mostly Often too little Very little

How satisfied are you with your overall physical appearance?

Very satisfied Satisfied Somewhat dissatisfied Very dissatisfied

How well do you recover after demanding days?

Very well Mostly well Not well Very poorly

How nutrient-dense is your daily diet (vitamins & antioxidants)?

Very nutrient-dense Mostly good Could be improved Poor

How often do you feel tired even after sleeping?

Never Rarely Often Very often

How consciously do you manage lifestyle factors (alcohol, stress, sleep)?

Very consciously Fairly consciously Not very consciously Not at all

How often do you feel internally exhausted?

Never Rarely Often Very often

How often do you feel internally exhausted?

How well does your body regenerate?

Very well Well Poorly Very poorly

How well does your body regenerate?

How high is your mental workload?

Low Moderate High Very high

How high is your mental workload?

How physically resilient do you feel day-to-day?

Very resilient Mostly resilient Somewhat limited Not resilient

How physically resilient do you feel day-to-day?

Note: This assessment does not replace medical diagnosis. If symptoms are severe or persistent, consult a healthcare professional.

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Date of birth *

Start the Assessment

What is your primary wellness goal right now?

How would you describe your daily energy level?

How often do you feel exhausted in the afternoon?

How hard is it for you to fall asleep?

How often do you wake up during the night?

How regular is your digestion?

How often do you experience bloating or fullness?

How often do you get sick per year?

How quickly do you recover after physical or mental strain?

How satisfied are you with your skin?

Does your skin tend to feel dry or dull?

How important is long-term health to you?

Do you feel signs of oxidative stress?

How easy is it for you to stay focused for extended periods?

Do you often experience brain fog or mental fatigue?

How active are you during the day?

How would you rate your nutrition?

Do you feel tired or sleepy after meals?

How often do you experience mood swings or irritability?

How would you rate your current stress level?

How refreshed do you feel when waking up?

How rested do you feel in the morning?

How often do you feel emotionally drained?

How strong are inner restlessness or nervousness?

How quickly does your body react physically to stress?

How well can you wind down in the evening?

Do you use screens regularly before bedtime?

How consistent is your sleep schedule?

Do you feel constantly on edge or wired?

Do you often feel heavy or unwell after meals?

How sensitive is your stomach to stress?

How often do you feel you don’t tolerate certain foods well?

How many servings of fruits/vegetables do you eat daily?

How often do you consume fiber-rich foods?

Have you taken antibiotics in the last 12 months?

How often do you struggle with an unsettled stomach?

Do digestive issues limit your overall energy?

Do you often feel low-energy?

How would you rate the connection between your sleep and recovery?

How much natural sunlight do you typically get per day?

How high is your stress level?

Do you feel more vulnerable to illness during winter months?

How balanced is your diet?

How often do you feel inflammatory discomfort (joints, fatigue, etc.)?

How good are your daily movement and fresh-air exposure?

How firm does your skin feel?

How would you describe your daily energy level?

Are you currently experiencing increased hair fall?

How often do you feel exhausted in the afternoon?

How would you rate your hair density?

How hard is it for you to fall asleep?

How strong and stable are your nails?

How often do you wake up during the night?

How stressed do you feel on a regular basis?

How regular is your digestion?

Is your diet rich in vitamins and minerals?

How often do you experience bloating or fullness?

Do you drink enough water daily?

How often do you get sick per year?

How satisfied are you with your overall physical appearance?

How quickly do you recover after physical or mental strain?

How well do you recover after demanding days?

How satisfied are you with your skin?

How nutrient-dense is your daily diet (vitamins & antioxidants)?

Does your skin tend to feel dry or dull?

How often do you feel tired even after sleeping?

How important is long-term health to you?

How consciously do you manage lifestyle factors (alcohol, stress, sleep)?

Do you feel signs of oxidative stress?

What is your primary wellness goal right now?

How easy is it for you to stay focused for extended periods?

Do you often experience brain fog or mental fatigue?

How active are you during the day?

How would you rate your nutrition?

Do you feel tired or sleepy after meals?

How often do you experience mood swings or irritability?

How would you rate your current stress level?

How refreshed do you feel when waking up?

How rested do you feel in the morning?