First Name *

Last Name *

Phone *

Email *

What is your gender (assigned at birth)? *

Male

Female

Prefer not to say

What best describes your situation? *

I’m about to start trying to get pregnant

I have started to try to get pregnant, and I’m getting concerned

I have been trying to get pregnant for over a year

I want to freeze my eggs AND I have been told I may have trouble getting pregnant

I want to freeze my eggs because I’m not ready to get pregnant yet, but I have NOT been told that I may have trouble getting pregnant

I am considering/starting IVF

I have had multiple miscarriages and I am afraid that I will not be able to carry to term

What best describes your situation? *

I’m about to start trying to get pregnant

I have started to try to get pregnant, and I’m getting concerned

I have been trying to get pregnant for over a year

I want to freeze my eggs AND I have been told I may have trouble getting pregnant

I want to freeze my eggs because I’m not ready to get pregnant yet, but I have NOT been told that I may have trouble getting pregnant

I am considering/starting IVF

I have had multiple miscarriages and I am afraid that I will not be able to carry to term

What best describes your situation? *

I’m about to start trying to get pregnant

I have started to try to get pregnant, and I’m getting concerned

I have been trying to get pregnant for over a year

I want to freeze my eggs AND I have been told I may have trouble getting pregnant

I want to freeze my eggs because I’m not ready to get pregnant yet, but I have NOT been told that I may have trouble getting pregnant

I am considering/starting IVF

I have had multiple miscarriages and I am afraid that I will not be able to carry to term

Have you been diagnosed with DOR (Diminished Ovarian Reserve)?Have you been diagnosed with endometriosis, fibroids, PCOS, or PMDD? *

Yes

Not sure

Have you been diagnosed with endometriosis, fibroids, PCOS, or PMDD? *

Yes

Not sure

Have you been diagnosed with unexplained infertility? *

Yes

Not sure

Has Your Fertility Been Evaluated By A Medical Provider? *

Yes

Not sure

How motivated are you to work on yourself to feel better? *

I am VERY MOTIVATED to do some work on myself.

I am INTERESTED IN STARTING some changes.

I am UNSURE how much energy I can dedicate to working on myself.

I am NOT READY to participate in changing my routine.

Do you understand that our practice is a cash-only practice? *

Yes

PLEASE TAKE DOWN YOUR RESULTS PRIOR TO SUBMITTING YOUR QUIZ

Good news! It looks like you just need a little support from us with our Baby Basics Program!

Here is the link for you: https://l.bttr.to/PjgPC

If you have any questions, please feel free to reach out!

You can easily start this program on your own through this link. We have created this affordable option for people just like you, so you can have access to all of our resources at a fraction of the cost of our high level wellness programs. Be sure to join our private community so we can answer your specific questions, and if you need more assistance along the way, be sure to reach out!

To discuss the details of the programs.

Here's a link for a Fertility Connection Call:

https://bit.ly/fertilityconnectioncall

PLEASE TAKE DOWN YOUR RESULTS PRIOR TO SUBMITTING YOUR QUIZ

Your quiz results demonstrate that you are a good candidate for our Core Moms Program.

Here is the link for you: https://l.bttr.to/2iHuT

If you have any questions, please feel free to reach out!

Core Moms, unlike Baby Basics, includes a supplement pack for optimization of your eggs for the duration of the 8 week program. Core Moms also includes a home biofeedback program that allows for relaxation, creating a better energy supply for egg health.

To discuss the details of the programs.

Here's a link for a Fertility Connection Call:

https://bit.ly/fertilityconnectioncall

PLEASE TAKE DOWN YOUR RESULTS PRIOR TO SUBMITTING YOUR QUIZ

Your quiz results demonstrated that you are a good candidate for either our Core Plus or VIP program.

Symptoms of fertility challenges can actually be expressed in ways that may not make sense, such as stomach issues, body pains, mood swings and difficulty sleeping. This can lead to a longer path to getting that dream baby, and requires a bit more help from us. Both our Core Plus and VIP programs offer personal support at different levels.

Please get on a call with us so we can decide together what is most important to you on your fertility journey and how we can support you best.

To discuss the details of the programs.

Here's a link for a Fertility Connection Call:

https://bit.ly/fertilityconnectioncall

Thank you for your answers!