Complete this quick assessment to find out if you may be suffering from weight-management issues or a hormonal imbalance. 

Submit this form to earn a 15% credit on your first order and a Free Blueprint Health Shaker Bottle!

Name *
Name
Phone
Phone
Question 1 - Body *
Do you have a decrease in muscle size, strength, or endurance overall?
Question 2 - Energy *
Do you have decreased energy? Feeling tired or fatigued?
Question 3 - Libido *
Do you have a decrease in libido (sex drive)?
Question 4 - Skin *
Do you suffer from oily or acne prone skin?
Question 5 - Activities *
Have you noticed a decreased enjoyment of life or activities?
Question 6 - Anxious *
Are you sad, depressed or anxious?
Question 7 - Eating *
Do you eat when you are bored/ stressed?
Question 8 - Mood *
Have you noticed any changes in mood?
Question 9 - Memory *
Do you find yourself struggling to remember things? Foggy brain?
Question 10 - Weight Gain *
Have you experienced any weight gain in the past 6 months?
Question 11 - Do You Have Health Insurance *
If you have Medicare or PPO commercial health insurance, your insurance may cover your hormone lab panel.