Before we begin

Let's get the full picture.

The more honest detail you give, the more precisely we can read your bloodwork. Answer what you can — estimates are fine, “I don't know” is a real answer, and your progress saves automatically as you go.

Who's filling this out?

Which units feel natural to you?

Chapter 1

Who you are.

The basics that calibrate every reference range to your body.

Legal name

Preferred name

Date of birth

Gender identity (if different)

Sex assigned at birth

Height

Feet

Inches

Current weight

Chapter 1 · continued

A little more about you.

A few details that sharpen how we read your numbers.

Weight ~6 months ago

Weight ~12 months ago

Waist

Where you live

Moved across a big elevation change in the last 3 months

Genetic ancestry — select all that apply

Chapter 2

What you take.

Every prescription and over-the-counter drug. Don't forget creams & serums (hair-loss, hydrocortisone, hormone creams), inhalers, nasal sprays, injections, patches, birth control, weight-loss shots, and acid reducers.

Chapter 3

Supplements & what they did.

One block per supplement — what it is, how you take it, and whether it actually helped. Don't worry about milligrams; "2 pills a day" is perfect.

Chapter 4

Your history.

Conditions, surgeries, reactions, and what runs in your family.

Blood transfusion or IV iron in the last 3 months

Conditions you've been diagnosed with

Surgeries & hospitalizations

Allergies & bad reactions

Has anybody in your family had these conditions? — tick any, then say who

Chapter 5

Day to day.

How do you eat?

Alcohol — drinks per week

Tobacco / vape / nicotine

Your build

I take creatine

Chapter 5 · continued

Digestion, sleep & the rest.

A fuller picture of your daily patterns sharpens how we read the numbers.

Bowel movements — how often

Typical stool form (Bristol)

Bloating

Reflux

Known gut conditions

Changed how I eat a lot in the last 3 months

Hours of sleep

Sleep quality

Night or rotating shift work

Sleep-apnea screen — tick any that are true

Loud snoring Someone's seen me stop breathing Unrefreshing sleep Morning headaches

Current stress

Major life events or trauma, past or present (only if you want to share)

Last alcoholic drink before the draw

Caffeine per day

Cannabis

Other recreational

Exercise — type & how often

Chapter 6

Hormones & blood loss.

Any hormones you take — select all that apply

Regular blood or plasma donor Therapeutic phlebotomy (e.g. for high iron)

Chapter 7

Your story.

This is the part the numbers can't tell us.

In your own words — what's the main reason you're here?

Your top goals, in order — add at least one

Chapter 7 · continued

The deeper context.

This is what makes the plan yours. A sentence or two on each — the fuller you are here, the sharper we can be.

When the main problem started

Is it…

What else was happening in your life around then?

How fast is it changing

What do you think is causing this?

What do you fear most?

What would “better” actually look like for you?

What's already been checked or tried — and the results?

When did you last feel completely well? What was that like?

Chapter 8

Your labs.

This is where you give us your bloodwork. Enter any values you have by hand below, and attach the lab files themselves — do both, either, or whatever you've got.

Lab values

Any blood work you have or remember — the marker, its value, and roughly when. Enter any labs not covered by the files you attach.

I have lab result files to attach

Attach lab files (PDF, image, CSV — including screenshots)

I have genetic / pharmacogenomic results

Attach genetics files (TXT, CSV, ZIP, VCF)

Attach as many as you like — one at a time. Tap “Add a file” for each. If an upload doesn't go through, no worry: your clinician will collect these directly.

Chapter 8 · continued

About your most recent labs.

A little context on the labs you're sharing — these small facts decide whether a result means what it says. Worth the two minutes.

When did you get these labs done?

Clock time

What time you woke that morning

Did you fast before this blood draw?

For your most recent labs, if you know:

Had water beforehand Had coffee beforehand

Hydration that morning

Took biotin in the 72 h before (hair/skin/nail, “energy”, B-complex) Iodine load in the last 2–4 weeks (CT dye, kelp/seaweed, amiodarone, povidone) Strenuous or unaccustomed exercise in the 24–72 h before Infection, illness, injury, surgery, or vaccine in the last 4 weeks

Your usual meds/supplements the morning of the draw

Any NSAID / pain reliever in the 7 days before (ibuprofen, naproxen, aspirin, high-dose acetaminophen)

Last step

That's everything.

Thank you for the care you put into this — it genuinely changes how well we can read your results.

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