Peptide Wellness Quiz

Name *

First Name

Last Name

Phone *

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1. What is your top aesthetic or health priority? *

(Select one option)

A. Glowing, youthful skin

B. More Energy & physical recovery

C. Improved mental clarity

D. Fat loss or lean muscle

2. What symptoms bother you most? *

(Select one option)

A. Skin dullness or visible aging

B. Low energy or slow recovery

C. Brain fog, anxiety, or poor sleep

D. Belly fat, bloating, or inflammation

3. How do you typically feel in the morning? *

(Select one option)

A. I look tired, even if I sleep well

B. I wake up stiff, sore, or still fatigued

C. I feel foggy, anxious, or unrefreshed

D. I feel inflamed, bloated, or heavy

4. What best describes your lifestyle goal? *

(Select one option)

A. I want to age gracefully and maintain glowing skin

B. I exercise regularly and want to recover faster

C. I feel mentally drained or under constant stress

D. I'm focused on fat loss, body composition, or gut health

5. Where do you want to see your biggest improvement? *

(Select one option)

A. Skin quality, glow, and appearance

B. Energy levels and physical performance

C. Focus, mood, and sleep quality

D. Fat metabolism, digestion, or inflammation

6. Do you often feel tired after a full night's sleep? *

(Select one option)

Yes

No

7. Are you struggling to lose fat or build muscle despite effort? *

(Select one option)

Yes

No

8. Do you have trouble falling asleep or feel unrested in the morning? *

(Select one option)

Yes

No

9. Are you experiencing low libido or interested in improving your sexual wellness? *

(Select one option)

Yes

No