New Patient Information
Here is the information you can request from new patients to help guide them through their program.
Pin the following as a note to the Hubspot profile of the new patient:
Current Program:
Current Shipping Address:
Referral Credits Usage:
About This Patient:
Health Goals:
Two unique things about you!
How did you find us?
Life at home (married, kids, single, what do they do for work?)
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Wake up at
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Married
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Kids (ages)
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Exercise
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Daycare
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Diet / Meal Prep
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School / Homework
- Work / Travel
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Bedtime at
Energy levels:
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Morning -
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Afternoon -
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Evening -
Sleep quality
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Trouble falling asleep?
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Diet:
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Sugar -
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Protein -
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Fruits and Vegetables -
Exercise:
Injuries:
Libido and sex drive:
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Women - ask about desire and lubrication
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Men - I usually ask about desire and function
If Woman
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Ask about menstrual cycle
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Typical length -
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Symptoms -
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Mental:
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focus is
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memory
Current Medications:
Supplements:
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Omega 3?
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Daily multi?
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Pre-workout?
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Recover daily support?
Hormones:
Peptides: