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Vitality Wellness Blueprint
Vitality Wellness Blueprint
Step
1
of 16
Welcome!
Get ready to experience a wellness journey tailored just for you. Simply complete and submit this form to have Thoryn AI create your personalized Vitality Wellness Blueprint - a dynamic health plan that evolves with your goals and needs. Gain continuous insights, proactive recommendations, and a smarter approach to achieving optimal well-being.
Privacy Policy
To ensure your privacy, please provide only your first name, a nickname, or an alias. AI is used to generate this report, so please do not include your last name to maintain anonymity. Your report will be sent exclusively to you via email. Rest assured, your information will remain confidential and will only be used to create your customized wellness plan. This guide is for informational purposes only and does not constitute medical or professional advice. This service does not provide medical diagnoses, treatments, or prescriptions. Consult a healthcare provider before making any health-related changes.
Check this box to proceed
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I allow this website to collect the submitted data.
To generate a personalized wellness plan tailored to your objectives, we’ll need to get to know you better by asking some personal questions.
Email Address
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First Name
*
Age
*
Gender
*
To make sure we're on the right track, we'd love to get some information about your wellness goals and objectives. Knowing what you're hoping to achieve will help us create a plan that's perfectly suited to your needs.
Primary Wellness Goals
What is your main objective? (Select one.)
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Weight Loss
Hormone Balance
Athletic Performance
Sexual Health
Fertility
Longevity & Anti-aging
Energy & Vitality
Skin Health & Appearance
Other (please specify below)
Please enter your main objective
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To make sure we're on the right track, we'd love to get some information about your wellness goals and objectives. Knowing what you're hoping to achieve will help us create a plan that's perfectly suited to your needs.
Secondary Goals
Would you like to focus on any additional wellness goals? (Select all that apply.)
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Better focus & mental clarity
Healthier skin & anti-aging
Stronger relationships
Improved emotional well-being
Better sleep quality
More confidence & self-esteem
Healthier digestion & gut
Stronger immune system & vitality
Less stress & better stress management
Other (please specify below)
Please enter your secondary goal
*
To make sure we're on the right track, we'd love to get some information about your wellness goals and objectives. Knowing what you're hoping to achieve will help us create a plan that's perfectly suited to your needs.
Desired Outcome
What specific results would you like to achieve?
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Example: Lose 5 lbs, Increase muscle mass, improve mental clarity, boost libido, etc.)
We collect your current health information—including body metrics, medical conditions, lab work, and medications—to create a personalized, safe, and effective wellness plan that aligns with your unique needs, minimizes risks, tracks measurable progress, and ensures sustainable, long-term results.
1. Body Metrics
Weight (lb)
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Height (ft & in)
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Other Biometrics (if known)
Enter the biometric and specify the value such as BMI, Blood pressure, Waist measurement (inches), etc. )
2. Medical Conditions & Allergies
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No
Yes (please specify below)
Please enter your medical condition or known allergies
*
3. Recent Lab Work in the last 6 months
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No
Yes (please specify below)
Please list any notable results of your lab work
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4. Are you currently taking any prescription medications?
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No
Yes (please specify below)
Please list the medications you are currently taking
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5. Do you currently take any supplements or vitamins?
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No
Yes (please specify below)
Please list the supplements or vitamins you are currently taking
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6. Have you used medical or peptide therapies before?
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No
Yes (please specify below)
Please list any therapies you used before
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(Example: GLP-1 medications (Ozempic, Wegovy), Peptides (e.g., PT-141, BPC-157, CJC-1295), Testosterone Therapy, etc)
This assessment is essential for generating a personalized wellness plan, as it provides key insights into your dietary habits, physical activity, sleep patterns, stress management, and overall well-being—ensuring recommendations are tailored to your unique needs and goals.
1. Nutrition & Diet
How would you describe your daily eating habits? (Select all that apply.)
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Balanced & Healthy – I eat a variety of whole foods, including fruits, vegetables, lean proteins, and whole grains.
High-Protein & Low-Carb – I focus on protein-rich foods and limit carbs to maintain energy and muscle mass.
Plant-Based – I primarily eat plant-based foods with little to no animal products.
Intermittent Fasting – I eat within a specific time window and fast for the remaining hours.
Fast Food & Processed Foods – My diet consists mainly of convenience foods and processed meals.
Inconsistent & Snacking Often – My eating habits are irregular, and I snack frequently.
Mindful & Moderation-Based – I try to eat mindfully and in moderation, without strict dietary rules.
Other (please specify below)
Please enter your eating habits and/or any dietary restrictions
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This assessment is essential for generating a personalized wellness plan, as it provides key insights into your dietary habits, physical activity, sleep patterns, stress management, and overall well-being—ensuring recommendations are tailored to your unique needs and goals.
2. Exercise & Physical Activity
What type of physical activity do you engage in? (Select one.)
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Sedentary – I don’t exercise regularly.
Light Activity – Walking, stretching, or yoga.
Moderate Activity – Gym workouts, jogging, or sports.
Active Lifestyle – Daily workouts, strength training, or intense cardio.
Very Active – High-intensity training, competitive sports, or athletic performance.
How often do you engage in physical activity?
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Rarely or never
1-2 times per week
3-4 times per week
5+ times per week
Every day
This assessment is essential for generating a personalized wellness plan, as it provides key insights into your dietary habits, physical activity, sleep patterns, stress management, and overall well-being—ensuring recommendations are tailored to your unique needs and goals.
3. Sleep Pattern
On average, how many hours do you sleep per night?
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Less than 4 hours
4–5 hours
6–7 hours
8-9 hours
10+ hours
How would you rate the quality of your sleep?
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1- Poor, 2- Fair, 3- Good, 4- Very Good, 5- Excellent
This assessment is essential for generating a personalized wellness plan, as it provides key insights into your dietary habits, physical activity, sleep patterns, stress management, and overall well-being—ensuring recommendations are tailored to your unique needs and goals.
4. Stress Management
How do you typically manage stress in your daily life? (Select all that apply.)
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Exercise & Movement – Do you engage in physical activities such as walking, yoga, or sports?
Mindfulness & Meditation – Do you practice meditation, deep breathing, or relaxation exercises?
Social Support – Do you talk to friends, family, or a therapist about your stress?
Healthy Lifestyle – Do you focus on good sleep, nutrition, and hydration to manage stress?
Time Management – Do you use planning, to-do lists, or other organizational tools?
Hobbies & Creative Outlets – Do you engage in activities like music, art, or reading?
Professional Help – Do you seek professional support like counseling or therapy?
Other (please specify below)
Please enter other way that you manage stress
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Your relationships, social connections, and sexual health play a big role in your overall well-being. By understanding your needs in these areas, we can provide personalized recommendations to help you build healthier connections, improve intimacy, and support your emotional and physical health.
Relationship & Social Support
1. Do you feel emotionally supported by your friends, family, or partner?
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Yes, always
Sometimes
No, I often feel alone
2. Do you experience conflicts or relationship difficulties that affect your well-being?
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Never or rarely
Sometimes, but manageable
Often, and it causes stress
Your relationships, social connections, and sexual health play a big role in your overall well-being. By understanding your needs in these areas, we can provide personalized recommendations to help you build healthier connections, improve intimacy, and support your emotional and physical health.
Sexual Health & Intimacy
1. Are you satisfied with your current level of intimacy and sexual health?
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Yes
Somewhat
No, I would like to improve
2. Do you experience any concerns regarding sexual health (e.g., low libido, pain, difficulty with arousal, or performance issues)?
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No concerns
Some concerns but not severe
Yes, it significantly affects my well-being
3. Do you experience stress or anxiety that impacts your sexual well-being?
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Yes
Sometimes
No
Tracking your progress and staying accountable is essential for long-term wellness success. By setting a commitment duration, identifying potential challenges, and choosing a check-in frequency, we can create a wellness plan that keeps you motivated and on track.
Setting Commitment Duration
1. How long are you committing to this wellness plan?
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1 month
3 months
6 months
1 year
Other (please specify below)
Please enter how long you are committing to this wellness plan
*
2. What obstacles might make it difficult for you to stay committed? (Select all that apply.)
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Lack of time
Lack of motivation
Stress or emotional difficulties
Unclear goals or direction
Lack of support from others
Other (please specify below)
Please enter what might make it difficult for you to stay committed
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Tracking your progress and staying accountable is essential for long-term wellness success. By setting a commitment duration, identifying potential challenges, and choosing a check-in frequency, we can create a wellness plan that keeps you motivated and on track.
Check-In & Tracking Progress
1. How often would you like to track your progress?
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Daily
Weekly
Biweekly
Monthly
2. What method will you use to track your progress?
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Journaling
Wellness app or tracker
Regular check-ins with a coach or therapist
Accountability partner/friend
Other (please specify below)
Please enter other method to track your progress
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3. How will you celebrate progress and small wins?
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Treat myself to something I enjoy
Share my progress with a friend or community
Reflect on how far I’ve come
Other (please specify below)
Please enter other ways how you will celebrate progress
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You did it! Just hit submit!
What Happens Next?
Your personalized Vitality Wellness Blueprint will be generated based on your responses. Expect to receive your plan via email by the next business day.
Follow-Up Recommendations
While this Vitality Wellness Blueprint provides tailored insights, we always recommend consulting with a healthcare provider or wellness expert before making major changes to your health routine. If you have lab results or medical history that may impact your plan, consider discussing them with a medical professional.
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Popular Therapies
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C2
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Rewards
Contact Us
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