How frequently do you experience energy crashes or fatigue that interfere with your daily routine?
*
never/not at all
rarely
sometimes
frequently
always/extremely
How frequently do you struggle to maintain your desired weight, despite healthy eating and activity efforts?
*
it's not a problem
rarely
more than I would like
I am on some kind of diet all of the time
it is so discouraging :(
How often do you feel bloated, gassy, or have irregular bowel movements, making you uncomfortable or self-conscious?
*
never/not at all
rarely
sometimes
frequently
always/extremely
How often do you feel overwhelmed by stress or notice it negatively affecting your mood, sleep, or daily activities?
*
never/not at all
rarely
sometimes
frequently
too often
How frequently do you feel emotionally unbalanced, anxious, or down—impacting your enjoyment of life?
*
never/not at all
rarely
sometimes
frequently
most of the time
How often do you neglect relaxation or mindfulness practices (e.g., meditation, yoga, deep breathing), despite wanting to feel calmer
*
rarely! I practice daily
once in a while
sometimes
frequently
pretty much all of the time
How frequently do unstable energy levels or mood swings make you feel short-tempered or cause tension in your relationships?
*
never/not at all
rarely
more than I would like
frequently
constantly
How frequently do menopause-related symptoms (hot flashes, night sweats, sleep disturbances) affect your quality of life?
*
never/not at all
rarely
sometimes but mild
regularily
extreme all of the time
How often do you wake up feeling tired or unrested, even after a full night’s sleep?
*
never/not at all
rarely
sometimes
more than half the time...
most mornings
How frequently do you have trouble sticking to a consistent sleep schedule?
*
I follow a set bedtime
rarely
sometimes
frequently
always
How often do you feel concerned about your exposure to environmental toxins (e.g., unfiltered water, polluted air, chemical-laden products, old silver fillings)?
*
rarely
occasionally
it's on my mind
frequently
I worry about it
How frequently do you consume processed or packaged foods, more than fresh, whole foods?
*
my meals are made from scratch
rarely
a mix of both
frequently
most meals are from a box, can or jar
How much has your immune system been more challenged in the past 5 years?
*
not at all
rarely
more frequent colds and flus
frequently
unwell a lot of the time
How often do you avoid or skip strength-training exercises, even though you know they’re important for maintaining muscle and bone health?
*
never/not at all
rarely
sometimes
most of the time
I'm not physically active
How frequently do you fall short of getting at least 30 minutes of moderate activity (like power-walking or swimming) a day?
*
never/not at all
rarely
sometimes
frequently
most of the time
How much longer is your list of aches, pains and injuries, that are getting in the way of being active?
*
it's a short list!
there are a few things on it
it is getting longer...
too long
it is becoming endless
How many illnesses have you been diagnosed with?
*
0
1
2
3
4
5 or more
How many different prescribed or over-the-counter medications do you take?
*
none
1
2
3
4
5 or more
How often do you worry that, if your health continues as it is, your life in 10 years will not be what you want it to be?
*
I'm on track to stay healthy!
I think about it when I'm having a bad day
It's on my mind
I am more observant of how people around me/family are aging
I'm worried!