1 / 24

Hi Pleasure Meeting You!

LET'S GO
The input field is required

←BACK

NEXT→

2 / 24

Your age?

The input field is required

←BACK

NEXT→

3 / 24

Select the goals you'd like to focus on

Skin

The input field is required
Immunity

The input field is required
Energy

The input field is required
Hair

The input field is required
Brain

The input field is required
Joints

The input field is required
Stress

The input field is required
Digestion

The input field is required
Heart

The input field is required
Weight

The input field is required
Focus

The input field is required
Sleep

The input field is required

←BACK

NEXT→

4 / 24

Let's talk about your menstrual history...

LET'S GO
The input field is required

←BACK

NEXT→

5 / 24

How old were you when you started your period?

The input field is required

←BACK

NEXT→

6 / 24

When did your last period start

Last 30 Days
The input field is required
More than 1-3 months
The input field is required
A little over 12 months
The input field is required
More than 2 years ago
The input field is required

←BACK

NEXT→

7 / 24

What are your most frequently experienced menstrual symptoms

Select as many

Sleeping Problems
The input field is required
Bloating
The input field is required
Sore Breasts
The input field is required
Back pain
The input field is required
Headache
The input field is required
Cramps
The input field is required
Stress
The input field is required
Mood Swings
The input field is required
Stress & Fatigue
The input field is required
UTI
The input field is required
Bacterial Vaginosis
The input field is required
Vaginal Irritation
The input field is required
IBS
The input field is required
Skin Breakouts
The input field is required
None of the above
The input field is required

←BACK

NEXT→

8 / 24

Let's know more about your monthly cycle

Nothing
The input field is required
Spotting
The input field is required
Less
The input field is required
Normal
The input field is required
Heavy
The input field is required

←BACK

NEXT→

9 / 24

How would you describe your typical cycle length

Regular
The input field is required
Subtle changes in flow or cycle
The input field is required
Varies by 7+ days
The input field is required
Spotting
The input field is required
Not Applicable
The input field is required

←BACK

NEXT→

10 / 24

When it comes to menopause, you:

know a lot about it
The input field is required
know a bit, want to learn more
The input field is required
are not sure yet
The input field is required
feel confused
The input field is required

←BACK

NEXT→

11 / 24

Are you going through an induced menopause as a result of treatment or surgery

Yes
The input field is required
No
The input field is required

←BACK

NEXT→

12 / 24

Have you taken any supplements or medication for menopause in the past?

Yes, for a while
The input field is required
Yes, currently on them
The input field is required
Doctor Recommended
The input field is required
Self-medication
The input field is required
No
The input field is required

←BACK

NEXT→

13 / 24

Are you taking HRT?

Yes
The input field is required
No
The input field is required

←BACK

NEXT→

14 / 24

Are you currently using any hormonal contraceptives

Yes
The input field is required
No
The input field is required

←BACK

NEXT→

15 / 24

Have you undergone any medical procedures?

I've had both ovaries removed
The input field is required
I've had one ovary removed
The input field is required
I've had my womb removed
The input field is required
i've had a practical hysterectomy
The input field is required
Cancer Treatment (Chemo/RTx)
The input field is required
Other
The input field is required
None of the above
The input field is required

←BACK

NEXT→

16 / 24

Have you ever been diagnosed with any condition?

Select as many

Anxiety
The input field is required
PMS/PMDD
The input field is required
Depression
The input field is required
Other Cancers
The input field is required
Fibroids/Uterine polyps
The input field is required
Pre/Postnatal Depression
The input field is required
PCOS
The input field is required
Adenomyosis
The input field is required
Endometriosis
The input field is required
Gestational Diabetes
The input field is required
Premature Ovarian Failure
The input field is required
Breast/Gynecological Cancer
The input field is required
Autoimmune Disease (Thyroid, Diabetes, Rh. Arthritis)
The input field is required
None of the above
The input field is required

←BACK

NEXT→

17 / 24

Any family history of...

PID
The input field is required
Diabetes
The input field is required
Heart Disease
The input field is required
Depression
The input field is required
Osteoporosis
The input field is required
Thyroid Diseases
The input field is required
Cancer
The input field is required
None of the above
The input field is required

←BACK

NEXT→

18 / 24

In the next few slides select the options you are currently undergoing

LET'S GO
The input field is required

←BACK

NEXT→

19 / 24

Let's talk about your Dermal Health

Select the one’s you’re experience now or in the last 3 months.

Change in skin texture,Taste & Smell
The input field is required
Hair Fall, Receding Hair Line
The input field is required
Acne
The input field is required
Vulvovaginitis
The input field is required
Vaginal Tears
The input field is required
Dryness of skin, nose, eyes, and mouth
The input field is required
Itchy Skin
The input field is required
Sore Breast
The input field is required
Perspiration
The input field is required
Alopecia
The input field is required
Hirsutism
The input field is required
None of the above
The input field is required

←BACK

NEXT→

20 / 24

Let's talk about your Physical Health

Select the one’s you’re experience now or in the last 3 months.

Bloating
The input field is required
Breathing Difficulties
The input field is required
Heart Palpitations
The input field is required
Hot Flashes
The input field is required
Joint Pain
The input field is required
Nausea and Digestive Problems
The input field is required
Tingling Extremities
The input field is required
Dental Problems
The input field is required
Fatigue
The input field is required
Feeling Cold
The input field is required
Loss of Muscle Tone
The input field is required
Sagging Breast
The input field is required
Weight Gain
The input field is required
None of the above
The input field is required

←BACK

NEXT→

21 / 24

Let's talk about your Sexual Health

Select the one’s you’re experience now or in the last 3 months.

Vaginal Dryness
The input field is required
Change in Sex Drive
The input field is required
Irregular Period
The input field is required
Worsening PMS
The input field is required
Change in Breast Size
The input field is required
Decrease in Fertility
The input field is required
Recurrent UTI
The input field is required
None of the above
The input field is required

←BACK

NEXT→

22 / 24

Let's talk about your Mental Health

Select the one’s you’re experience now or in the last 3 months.

ADHD
The input field is required
Dizziness
The input field is required
Loss of Confidence and Self-esteem
The input field is required
Brain Fog
The input field is required
Depression
The input field is required
Headaches and Migraines
The input field is required
Fatigue
The input field is required
Short-term Memory Loss
The input field is required
Anxiety
The input field is required
Lack of Motivation
The input field is required
Loss of Concentration
The input field is required
Sleep issues and Insomnia
The input field is required
Mood Swings
The input field is required
Irritability
The input field is required
Panic Disorder
The input field is required
None of the above
The input field is required

←BACK

NEXT→

23 / 24

Select the TOP 2 goals you'd like to focus on...

Mental Health

The input field is required
Physical health

The input field is required
Dermal Health

The input field is required
Sexual Health

The input field is required

←BACK

NEXT→

24 / 24

Hey !

Let’s begin your menopausal journey by generating your personalized plan.

←BACK

NEXT→