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WHERE IS YOUR HORMONAL BODY AT?

To help me to better support you, please fill out the questions. Related to your individual physical Hormonal profile. This assessment is for females only.

 

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Question 1 of 14

What Age range do you fall under?

A

In my teens

B

In my 20's

C

In my 30's

D

In my 40's

E

in my 50's

F

In my 60's

G

Above the Age of 68 Yrs of Age

Question 2 of 14

Do you workout? 

A

yes

B

no

Question 3 of 14

Do you have irregular periods? You are unsure when it comes.

A

YES

B

NO

Question 4 of 14

Do you have a monthly period consistently every month?

A

Yes

B

No

Question 5 of 14

Do you take any contraceptives(pills/IUD/ devices) to prevent pregnancy or was given due to heavy bleeding?

A

YES

B

NO

Question 6 of 14

 

Are you in menopause? (Having no period for over 12 months)

A

Yes

B

No

C

Surgical Menopause

Question 7 of 14

Do you think you might be going through perimenopause? (Perimenopause can start as early at 35 yrs of age. If irregular period consistently it could start earlier.)

A

Yes

B

no

C

I don't know what perimenopause is, this is the 1st I am hearing about this.

Question 8 of 14

THIS IS IMPORTANT RELATED TO YOUR MUSCLE IMBALANCE AND HOW YOU CURRENTLY TRAIN.  Where have you had Surgery on your body? (choose multiple)

(Select all that apply)
A

A1:Brain

B

A2:Face

C

A3:Eyes

D

A4:Throat/Neck

E

A5:Shoulders

F

A6:Arms

G

A7:Hands

H

A8:Elbow

I

A9:Fingers/ Thumb

J

A10:Hip

K

A11:Spine

L

A12:Knee

M

A13:Ankle

N

A14:Feet

O

A15:Toes

P

A16:Leg/ Quads (front of leg)

Q

A17:Legs/Hamstring (back of leg)

R

No surgery

Question 9 of 14

 

What is your workout environment like? Do you workout...

A

At a local free weight gym( I show up and workout)

B

At a franchise location (orange Theory/ F45/Strong Pilates/ Fit Body Boot Camp ect.)

C

workout at a speciality boutique gym (pilates/yoga/private training/boxing)

D

Workout at home

Question 10 of 14

Have you done any Fertility treatments in the past?

A

YES

B

NO

Question 11 of 14

 

Do you take any hormone replacement therapy currently right now?

A

YES

B

NO

Question 12 of 14

Are you (in relation to your hormones)

(Select all that apply)
A

married

B

single

C

new mom

D

single mom

E

in a relationship

F

mom

G

a mom of a daughter

Question 13 of 14

At what stage are you at or interested in self discovering?

(Select all that apply)
A

Using my hormones as an asset in my MUSCLE BUILDING

B

Learning how to train more effectively on the gym floor the feminine hormonal way, WHILE I STILL CONTINUE TO DO MY WORKOUTS.

C

Avoid Pain in my training routine, understanding the hormone shifts

D

Learning how MY hormones and MY calories change each day of MY cycle

E

Discovering when mobility is best in my hormonal phases and after my muscle development phase.

F

A consultation call

Question 14 of 14

Thank you for taking the time to fill out these questions. We are uniquely individually hormonally, metabolically, and body wise. You will receive a email with a series of videos custom to your individual response. I look forward to supporting you on what ever journey you are on:)

A

Thank you

B

I look forward to your video series!

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