How Can I Help?
Welcome, please answer the below questions to the best of your ability, so I can better help you on your journey of self-optimization starting on a cellular level to be the best version of you possible. I look forward to learning more about you in the hopes that I can inspire you and provide valuable information to enhance the rest of your life. -Donna EG Haugen
How can I help you? Please describe your current top 3 challenges.
Are you happy with your current weight or would you like to lose some weight/body fat, and if so, how much would you like to lose?
Describe your current body and if you're content with what you see and if not what would you like to change? ie; I would like to lose a little body fat, increase bone density, and muscle mass.
*Please check the box below to confirm that you understand that this form is not Hippa Compliant
I understand that this form is not HIPPA Compliant
Perimenopause, Menopause, Postmenopause & Hormones
It's important for me to know if you are perimenopausal, in menopause or postmenopausal. Also, if you have had your hormone levels checked recently, and if you are currently on any hormone replacement, bioidentical or otherwise.
Your hormone levels can affect your weight, the quality of your sleep, and how your brain is functioning. Without the proper levels of hormones, it can seem as if our memory is slipping, we can't think clearly, and we aren't handling stress as well as we may be able too.
Hormones imbalances or lack of hormones can also, cause us to carry excessive weight around our midsection, make it difficult to build and keep muscle mass and cause us to lose valuable bone density.
Furthermore, if you have had hormone-positive breast cancer you may be feeling cautious about supplementing with hormones and looking for alternative natural ways to overcome the lack of hormones. I can help with this. I am very knowledgeable in being able to optimize with other modalities besides hormones when necessary, as this was a part of my journey due to estrogen-positive breast cancer. I call it biohacking!
Please answer the following questions in as much detail as you are comfortable with providing me. This will enable me to assess overall how I can best guide you to better health and vitality.
Please note that I am not a doctor, although I have knowledge of hormone replacement and can help find the right hormone replacement specialist if necessary.
Have you had your hormone levels checked recently?
If you answered yes to the above question, please check all boxes that are applicable.*
Estrogen - Normal
Estrogen - Low
Progesterone - Normal
Progesterone - Low
Are you currently on hormone replacement therapy?
Could you please describe your sleeping habits and quality of sleep?
Could you please describe your eating habits?
Could please describe your movement or exercise habits?
Do you regularly take supplements?
Do you have any past major health issues such as breast cancer or autoimmune diseases that you would like to share with me?*
Do you have any current health issues that you would like to share with me?
Please share any other information below that you believe could help me to help you!
What is your "Why"? Why do you want to upgrade your health and ultimately your life and be the best version of you? Identifying your "why" can be very motivational and remembering and focusing on your "why" daily is the first step in being able to make life-changing shifts in your daily habits. Please take a moment, and share your "why" with me.
Thank you for taking the time to introduce yourself. I will be contacting you shortly to schedule your free 30-minute consultation! - Donna EG Haugen
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Oh-Jus Life, LLC.