User Information
Please fill out the form to receive recommendations for improving your health. Enter the data based on your test results and fitness trackers. You will receive our recommendations by email.
Full name
*
First Name
Last Name
Email
*
Email
example@example.com
Date of birth
*
-
Day
-
Month
Year
Date Picker Icon
What is your gender?
*
Please Select
Male
Female
N/A
Primary goal
*
Please Select
Weight loss
Muscle gain
Improve physical fitness
Improve sleep quality
Reduce stress
Optimize health and longevity
Manage chronic conditions
Increase energy levels
Choose the main goal of using the platform
Height
*
In centimeters
Weight
*
In kilograms
Lifestyle and Habits
What is your activity level?
Please Select
Sedentary (office work, minimal activity)
Moderately active (light workouts 1-2 times a week)
Active (workouts 3-4 times a week)
Athletic (intensive workouts 5+ times a week)
I usually sleep from
*
Hour Minutes
AM
PM
AM/PM Option
to
until
Hour Minutes
AM
PM
AM/PM Option
Total 0.0
Do you have any sleep issues?
Yes, I struggle to fall asleep
Yes, I frequently wake up at night
Yes, I wake up feeling tired
No, I sleep well
How would you rate your stress level on a scale from 1 - completely calm to 10 - extreme stress?
*
1
2
3
4
5
6
7
8
9
10
Do you use any relaxation techniques?
Yes, meditation / yoga / breathing exercises etc.
Occasionally, when I feel tense
No, but I’d like to try
No
Physical Activity and Workouts
What types of workouts do you prefer? (Select all that apply)
Cardio (running, swimming, cycling )
Strength training
Yoga, Pilates
HIIT, functional training
Other
How often do you exercise?
1-2 times per week
3-4 times per week
5+ times per week
Not currently, but I want to start
Do you have any injuries or physical limitations?
*
No
Yes
Nutrition and Dietary Habits
What is your current diet type?
*
I don't use any diets
Balanced diet
Vegetarian / Vegan
Keto
Low-carb
Mediterranean diet
Other
How often do you eat?
1-2 times per day
3-4 times per day
5+ times per day
Do you have any allergies or intolerances?
*
Lactose
Gluten
Nuts
Fish and seafood
No
Other
What is your favorite food?
No
Other
What food do you dislike?
No
Other
Medical History & Biometrics
Do you have any chronic conditions? (Select all that apply)
*
Hypertension
Thyroid disorders
Digestive issues (gastritis, colitis, etc.)
Autoimmune diseases
No
Other
Do you have any genetic predispositions to diseases?
*
No
Yes
Are you taking any medications or supplements? (If yes, specify)
No
Yes
Heart Rate Variability (HRV)
Take it from fitness tracker if you use
Total Body Water (TBW)
Take it from the scales if you have
Body Fat Percentage
Take it from the scales if you have
Muscle Mass Percentage
Take it from the scales if you have
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