2-Week Vitals Assessment

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- Amy Mckinlay
- Matt Mckinlay
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- Regenerative and Joint
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208.380.8825

You're just getting started, and even small changes matter!

Rate each of the following areas on a scale of 1-10

(1 = worst self, 10 = best self: balanced, energized, and thriving)

2-Week Vitals Assessment

Overall Energy Levels? *

Mood & Emotional Balance? *

Sleep Quality? *

a. How many hours of sleep do you average each night? *

Physical Vitality (e.g., strength, stamina, and ease of movement)? *

Sex drive, libido & satisfaction? *

Mental Clarity & Focus? *

Weight Management Progress? *

Gut Health & Digestion? *

Which areas have you noticed the most improvement since starting? *

Where can we help you focus more? *

Any small tweaks or side effects you’ve noticed? (injection site tenderness, changes to appetite mild nausea) *

None

YesYes

What small shift makes you proud or glad you started? *

On a scale of 1-10, how easy has it been to stick to your new optimization routine? (1 = Really challenging, 10 = Seamless habit) *

What one tweak would make it even easier? *

On a scale of 1-10, how likely are you to recommend a customized program to someone you care about? (1 = Not very likely, 10 = I’m going to tell everyone) *

If you are human, leave this field blank.

Pocatello

208.380.8825 333 N 18th Ave, STE D1,
Pocatello, ID 83201 GET DIRECTIONS

business hours

Mo, We, Th, Fr

9AM - 5PM

12PM - 6:30PM

208.380.8825

Twin Falls

208.758.8586 1285 Florence Ave, Twin
Falls, ID 83301 GET DIRECTIONS

business hours

Tu, We, Th

9AM - 5PM

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