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Free Mini Health Assessment

This free mini health assessment is designed to give you a deeper look at what your symptoms may be pointing to—and what kind of support might actually help.

It takes less than 5 minutes and is reviewed personally by our clinic.
Think of it as your first step in exploring the terrain beneath your symptoms and tuning into what your body is trying to tell you.
What You'll Receive:
→ Insight into where your system may be asking for support
→ Personalized reflections based on your responses
→ A suggested next step—whether that’s a resource, a reflection, or a conversation

Email Address

Name

1. Symptom Check-In

Which of the following are you currently experiencing (or experience regularly)?
 (Check all that apply)

Energy & Mood

Energy & Mood

Digestion

Digestion

Hormones, Cycle & Sexual Health

Hormones, Cycle & Sexual Health

Skin + Elimination

Skin + Elimination

Pain + Muscles

Pain + Muscles

Immune + Heart

Immune + Heart

2. Terrain Pattern Filters

These questions help identify subtle qualities beneath your symptoms

How often do you feel bloated, gassy, or heavy after meals?

How often do you feel bloated, gassy, or heavy after meals?
A
B
C
D

Do you tend to feel cold or hot most of the time?

Do you tend to feel cold or hot most of the time?
A
B
C
D

Do you feel more…

Do you feel more…
A
B
C

Would you describe yourself as more…

Would you describe yourself as more…
A
B
C
D

What is your default emotional state (Ex: Content, weary, anxious etc.)

How frequently are you having a bowel movement

How frequently are you having a bowel movement
A
B
C
D
E

3. What You’ve Tried

What have you already tried to get relief? (Check all that apply)

What have you already tried to get relief? (Check all that apply)

4. Reflective Prompts

How much are your symptoms affecting your life? (10 being high)

How much are your symptoms affecting your life? (10 being high)

How hopeful do you feel about getting better? (10 being Very hopeful)

How hopeful do you feel about getting better? (10 being Very hopeful)

How ready do you feel to receive support?(10 is Ready)

How ready do you feel to receive support?(10 is Ready)

If something could shift overnight and help you feel more like you again, what would it be?

If your symptoms improved, what would change in your life?

5. Support Preferences

What kind of support would feel most helpful to you right now?
 (Check all that apply)
If your symptoms improved, what would change in your life?

6. Final Notes

Is there anything else you'd like us to know about your health or story?

What Happens Next

We’ll personally review your responses and send you a brief reflection with insight or a next step that could support your healing path.

In the meantime, check your email for supportive resources that may already help ease some of what you're experiencing.

Feeling ready to talk now? You can skip the line and book your free Clarity Call here:👉 Book Clarity Call

With gratitude,

Please Note

This assessment is for educational purposes only and is not intended to diagnose, treat, or cure any condition. Your responses help us understand where your system may be asking for support from a holistic perspective.