Page 1 of 6

METABOLIC HEALTH FOR WOMEN:

WEIGHT * HORMONES * PCOS * MENOPAUSE * LIFESTYLE

We are designing a doctor -led online metabolic health program for women. Your input will help us create practical, science backed support for weight, hormones, PCOS, insulin resistance, menopause, emotional eating, energy, sleep & overall well being.

This short survey will take less than 7 minutes and will help us design a program that is practical,personalised and truly useful for women like you.

Your responses are confidential

SECTION 1: ABOUT YOU

What is your age group? (Mandatory)

*

What is your age group? (Mandatory)

A

21-30

B

31-40

C

41-50

D

51-60

E

61-70

F

71 onwards

Which city do you live in ?

Which best describes your current stage of life? ( Mandatory)

*

Which best describes your current stage of life? ( Mandatory)

Single

Married

Married with children

Perimenopause

Menopause

Other

Which of the following best describes your health concerns? ( Mandatory- select all that apply)

*

Which of the following best describes your health concerns? ( Mandatory- select all that apply)

Weight gain

Belly Fat

PCOS

Insulin resistance

Prediabetes

Type 2 Diabetes

Emotional Eating

Stress Eating

Poor sleep

Fatigue/low energy

Menopause Symptoms

Irregular periods

Thyroid issues

High Cholesterol

High Blood Pressure

Lack of Exercise

Poor Eating Habits

Digestive issues/ Bloating

Other