More Energy More Life

*

You're here because you're ready.
Now I’d love to learn more about you. Fill out the short application below to take the next step.

Name

First Name

Last Name

We’ll send you your free Hormone & Energy Starter Kit

Phone

For program updates or early access invites (optional)

(###)

###

####

What is your biggest Health and Wellness concern right now?

What symptoms or challenges are you dealing with right now?

Do you frequently experience low Energy levels?

When is your energy typically the lowest?

(e.g., morning, 2–4 p.m., after meals, evenings…)

What does low energy feel like in your body?

(e.g., brain fog, wired but tired, heavy limbs, no motivation, etc.)

What have you already tried to improve your energy or balance your hormones?

How is your low energy affecting your daily life?

Think: your mood, work, relationships, workouts, or just feeling like yourself.

How much are hormone-related symptoms affecting your daily life?

On a scale of 1–10 (1 = not much, 10 = it’s taking over)

Which of these challenges apply to you? (select all that apply)

What would it mean to you to feel clear, energized, and steady in your body again?

Optional: Annual spend on health/performance (per person)

If you are comfortable sharing

$0 - $1,000

$1,000 - $5,000

$5,000 - $10,000

$10,000 - $50,000

More than $50,000

Is there anything else you would like to share with me?