What best describes your lifestyle? *

Staying focused and motivated throughout the day

Reducing stress and finding more calm

Improving my physical health/fitness

Supporting overall gut health and well-being

Feeling more balanced and “like myself” again

If you had to simplify your wellness needs into one word, it would be… *

Busy and ambitious—it’s hard to stay balanced

Chaotic or overstimulated—I need grounding

Active, or wanting to get back into a fitness routine

Balanced-ish—I try to prioritize whole-body wellness

Shifting—I feel like my body or hormones are changing

Which of these do you find yourself craving most right now? *

Energy to actually get things done

A calmer mood and less stress

Better sleep and real rest

A clear mind without the brain fog

Feeling steady and more like “me” again

What’s your biggest barrier to wellness right now? *

Lack of motivation or burnout

Stress or poor sleep

Inconsistent movement or recovery

Digestive discomfort or sluggishness

Feeling tired or unbalanced

What time of day do you need the most support? *

Morning—I need energy to start strong

Evening—I want help winding down

Around workouts—pre or post

Throughout the day—I want steady support

It depends—I’m up and down all day

How would you rate your ability to focus and stay present? *

Laser-focused

Decent, but could be better

All over the place most days

How’s your overall mood lately? *

Very flexible, transitions easily

Sometimes resistant but manageable

Often struggles and needs extra support

Major struggle, transitions almost always cause a breakdown

How well are you sleeping? *

Fall asleep easily and sleep through the night

Takes me a while to unwind

Wake up tired or toss and turn a lot

Wake up every night at 3am

How would you describe your stress levels right now? *

Pretty chill

Manageable but noticeable

Stress is high and taking a toll

Stress or just crazy busy??

If your body could talk, it would say… *

“Help me focus!”

“Let me rest.”

“Move me more!”

“Let’s get in sync.”

“Something’s off.”

Your day feels best when you… *

Check off your to-do list with energy to spare

Have a moment to breathe and reset

Get in a workout or move your body

Take care of yourself from the inside-out

Feel in control with a steady mood

What’s your relationship with supplements? *

I love them—I’m focused on peak performance

I use them for stress + sleep support

I take them mainly for physical wellness

I take a probiotic or vitamin but want to do more

I’m just getting started/keeping it simple

What kind of support are you most curious about right now? *

Brain health and focus

Tools for stress + sleep

Fitness + recovery

Gut-brain connection and digestion

Hormone support and aging well

What’s your approach to haircare? *

Keep it simple, just want it healthy

Restore strength from dryness/breakage

Balance scalp + reduce excess oil

Prioritize hair health + reduce fallout

Which hair challenge feels most pressing? *

None specific, just want to keep it well

Dry/frizzy/brittle from styling or color

Oily scalp, frequent washes

Shedding, thinning, or lack of volume

What matters most in your hair routine? *

Leveling up from no routine

Visible results + healthier hair

Scalp balance, fresh roots

Lightweight support for fullness

Do you have kids at home—and would you be interested in natural support for their focus, sleep, or big emotions? *

Yes, I’d love to know more

Yes, but not right now

No kids at home

Are you interested in skincare that is formulated through neuroscience? *

curious...

No, Thanks

YESSSSSS

If you could change one thing about how you feel day to day, what would it be? *

First & Last Name *

Phone *

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Email *

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