Peptide Optimization Assessment

Clinical Assessment

Peptide Optimization
Assessment

Complete the short assessment below. Your answers help guide a provider toward a more personalized peptide and supplement strategy.

Step 1 of 5 20%

Getting started

Your contact details

Your information is kept private and used only to deliver your personalized assessment report.

Full Name

Email Address

Phone Number

Age

Sex at Birth

Male

Female

Weight

Height

Please fill in all fields before continuing.

Core assessment

Goals & baseline health

These answers determine your top peptide pathway before the deeper follow-up questions appear.

1. Primary goals Select all that apply

Fat loss / metabolic health

Muscle / performance

Recovery / injury healing

Longevity / anti-aging

Brain / cognitive performance

Immune / inflammation support

Skin / hair optimization

2. Secondary improvements Select all that apply

Energy

Sleep

Recovery speed

Inflammation

Body composition

Brain fog

Gut health

Libido / hormones

3. Energy level

4. Sleep quality

5. Activity level

6. Body composition

7. Recovery speed

8. Peptide experience

9. Brain fog or focus issues?

10. Chronic pain or injury?

11. Digestive / gut symptoms? Select all that apply

Bloating

Reflux / Heartburn

Constipation

Diarrhea

None

If any gut symptoms — how severe?

Please answer all required questions before continuing.

Pathway deep dive

Personalized follow-up

These questions are tailored to your top-scoring pathways from the core assessment.

Please answer all required questions before continuing.

Safety & preferences

Personalization factors

This helps the provider adjust intensity, frequency, and whether to keep the plan more conservative.

Autoimmune condition?

Yes

No

Active cancer or cancer history requiring caution?

Yes

No

Pregnant or breastfeeding?

Yes

No

Cardiovascular disease or major cardiac history?

Yes

No

GLP-1 Therapy Interest

GLP-1 medications support more than weight loss — they have proven cardiovascular, metabolic, anti-aging, and longevity benefits including at microdose levels.

Are you interested in learning about GLP-1 therapy?

Have you tried GLP-1 medications before?

Do you have any of the following? Select all that apply

Type 2 diabetes or pre-diabetes

Cardiovascular disease or risk factors

High cholesterol or triglycerides

Fatty liver

None of the above

Injection preference

Budget level

Dosing frequency preference

Open to supportive supplements?

Anything else the provider should know? Optional

Please answer all required questions before continuing.

Final step

Review your answers

Look over your responses before submitting. A licensed provider will review your assessment.

By submitting you confirm that your answers are accurate to the best of your knowledge. This assessment does not constitute medical advice.

Submission failed. Please check your connection and try again.

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Almost there!

Don't go away — your personalized report is generating right now.

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Analyzing your results…

We're matching your pathways to the best peptides and supplements for your profile. Your personalized plan will appear in just a few seconds.

Preparing your results…

A licensed provider will also review your full assessment and follow up if appropriate.