Question 1 of 9
What brought you here?
Sets the tone of the conversation — not the panel itself
Question 2 of 9
And biologically?
So we can include the right sex-specific markers
Question 3 of 9
Where in life are you?
Question 4(a) of 9
Have you gone 12 months or more without a period?
Question 4(b) of 9
Do you have any concerns about your menstrual cycles?
Irregularity, heavy bleeding, pain, bloating, premenstrual symptoms, etc.
Question 4(c) of 9
Menstrual cycle screening
Menstrual history (Optional)
First day of your last menstrual period (LMP)
Cycle regularity (past 6 months)
Premenstrual symptoms (PMS)
Severity (Optional)
Symptoms (Optional)
Menstrual bleeding profile
Flow
Duration
Have you noticed any of these? (Optional)
Menopause screening (Optional)
Would you like to complete the menopause symptom questionnaire?
Question 4(d) of 9
Menopause screening (Modified Greene)
Symptom score. Each symptom is scored based on severity.
0 = None | 1 = Mild | 2 = Moderate | 3 = Severe.
Total score is the sum of all symptoms, used to monitor change over time.
This tool is for symptom tracking only and is not diagnostic of menopause.
Over the past 4 weeks…
Hot flushes
Light headed feelings
Headaches
Brain fog
Irritability
Depression
Unloved feelings
Anxiety
Mood changes
Sleeplessness
Unusual tiredness
Backache
Joint pains
Muscle pains
New facial hair
Dry skin
Crawling feelings under skin
Less sexual feelings
Dry vagina
Uncomfortable intercourse
Urinary frequency
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Question 5 of 9
How familiar are you with lab testing?
Helps us pitch the rationale at the right depth
Question 6 of 9
Which of these matter most to you right now?
Pick up to three
Question 7 of 9
Any family history of…
Select any that apply
Question 8 of 9
How would you describe your current state?
Question 9 of 9
What's been on your mind lately?
Pick any that apply — these directly shape your panel
Last step to your plan
*Mandatory fields