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Expert health insights, treatment guides, and wellness tips for women from our clinician-led team.

Peptide Therapy

Intake Questionnaire

This questionnaire helps our clinical team understand your health history and goals. It takes about 5 minutes to complete.

Step 1 of 9

Your Details

Let’s start with your contact information.

HubSpot form will go here.

Step 2 of 9

Bloodwork & Diagnostics

Have you completed any recent blood tests?

HubSpot form will go here.

Step 3 of 9

Medical History

Help us understand your health background.

HubSpot form will go here.

Step 4 of 9

Peptide & Treatment History

Any prior experience with similar treatments?

HubSpot form will go here.

Step 5 of 9

Current Symptoms

Select all symptoms you’re currently experiencing.

HubSpot form will go here.

Step 6 of 9

Lifestyle & Habits

A few questions about your daily habits.

HubSpot form will go here.

Step 7 of 9

Activity & Exercise

Tell us about your current activity levels.

HubSpot form will go here.

Step 8 of 9

Goals & Expectations

What are you hoping to achieve?

HubSpot form will go here.

Step 9 of 9

Sleep & Recovery

Final section — tell us about your sleep.

HubSpot form will go here.

Review & Sign Consent

Please read the consent terms below. To continue, confirm your agreement and electronically sign.

Type your full legal name below to sign

ID Verification

Please upload a photo of your driver’s licence for identity verification.

ID Preview

Your ID is securely stored and used solely for identity verification as required by Australian telehealth regulations. It will not be shared with third parties.

Book Your Consultation

Payment

Secure your initial consultation with our clinical team.

Initial Consultation $150.00
GST (10%) $15.00
Total $165.00
Secure, encrypted payment

You’re Booked

Your consultation has been booked and payment has been received. Our clinical team will review your questionnaire and be in touch to schedule your appointment.