Metabolic Health Assessment Quiz
Evaluate your metabolic health by answering the following questions. Your responses will help identify potential risk factors and areas for improvement.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Age
*
Gender
*
Male
Female
Other
How often do you engage in physical activity each week?
*
Rarely or never
1-2 times/week
3-4 times/week
5 or more times/week
How would you rate your typical daily energy levels?
*
Very low
1
2
3
4
Very high
5
1 is Very low, 5 is Very high
In the past 6 months, have you experienced any unintentional weight changes?
*
No significant change
Gained weight
Lost weight
Not sure
How often do you consume processed or sugary foods?
*
Rarely or never
Occasionally (1-2 times/week)
Frequently (3-5 times/week)
Daily
Please indicate if you experience any of the following symptoms regularly:
*
Rows
Never
Rarely
Sometimes
Often
Fatigue
1
2
3
4
Brain fog
5
6
7
8
Frequent thirst
9
10
11
12
Frequent urination
13
14
15
16
Cravings for sweets/carbs
17
18
19
20
Do you have a family history of metabolic conditions (e.g., diabetes, high blood pressure, high cholesterol)?
*
Yes
No
Not sure
How would you describe your typical sleep quality?
*
Very poor
1
2
3
4
Excellent
5
1 is Very poor, 5 is Excellent
Is there anything else about your health or lifestyle you'd like to share? (optional)
Submit Assessment
Should be Empty: