4-Month Vitals Assessment

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- Matt Mckinlay
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208.380.8825

Let's see the progress. How has your life changed?

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

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

4-Month Vitals Assessment

Energy levels throughout the day? *

How stable and positive do you feel emotionally? *

Sleep Quality? *

How many hours of sleep have you averaged over the last 4 months? *

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

Sex drive, libido & satisfaction? *

How clear, focused and mentally sharp do you feel day to day? *

Weight & Body Composition? *

Gut Health & Digestion? *

Which initial symptoms since your blood draw show the biggest, lasting change? *

Recalling your blood draw results, how has consistency changed your confidence in your intial core areas of concern? *

Looking ahead, how committed are you to continuing your treatment? (1 = Not likely, 10 = Absolutely) *

What would make continuing on the program feel essential for your to continue? *

Please share a ‘win-story’ from the last 3-4 months tied to one or more of these: (energy, sleep, emotional stability, physcial vitality, sex drive, libido, brain fog, weight loss)

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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