This quiz currently only works on desktop. Mobile support is coming soon.
Your provider has asked you to complete a brief questionnaire designed to better understand the symptoms you're experiencing and what may be contributing to them. This tool looks at patterns across three key areas that often influence hormone balance and overall well-being.
Your responses will help guide personalized recommendations that may support your body, particularly in areas related to hormonal health. While lab testing can offer deeper insight and is often used when available, this questionnaire provides a meaningful starting point to better understand your current experience and needs.
This is not a diagnostic tool, but rather a way to support thoughtful, individualized care. Your provider will interpret your results within the context of your full health picture and use their clinical judgment to guide next steps.
Please answer each question as honestly and accurately as you can - your input is an important part of your care. If there are questions you do not know the answer to, please leave them blank and let your provider know.
1. Hormone / Progesterone-Estrogen — core hormone pattern
2. Detox — hormone clearance & metabolism
3. Adrenal Health — cortisol & stress response
Before taking any quiz, please note:
This quiz is not intended for use if the patient:
- Is pregnant or breastfeeding
- Has a history of a hormone-sensitive cancer
- Is actively taking hormonal contraception, including oral combination pills, the mini-pill (progestin-only), a hormonal IUD, an Implanon, or the Depo-Provera shot
- Has a diagnosis of Cushing's syndrome, Addison's disease, or any pituitary or adrenal tumor
Please note:
- For women on hormonal contraceptives: consider adding Formula 12 (our antioxidant blend) and Formula 24 (our birth control multivitamin). All other products are contraindicated without further testing.
- If the patient has PCOS: the PCOS screening pathway is now available within this tool. Select "Cycling" and check the PCOS option in the triage screen.
