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FREE Health
Assessment

The TrueMedX FREE Health Assessment helps you to identify potential health risks. After you complete the assessment, you will receive personalized product recommendations to help you achieve your health and wellness goals to live a better quality of life!

Welcome to the TrueMedX Assessment Form! This form is intended to give a customer a rough idea of how their conditions or symptoms might map to a TrueMedX product. THIS TOOL IS NOT DESIGNED TO ASSESS OR DIAGNOSE ANY DISEASE OR DISEASE STATE. This tool is merely informational. If you are concerned about your health please consult a health professional!

Name(Required)

First Last

Email(Required)

Phone(Required)

Consent(Required)

I agree and acknowledge that this assessment is for informational purposes ONLY and is NOT intended to diagnose or treat disease!

General Information

I identify as a...(Required)

My age is...(Required)

Please enter a number from 0 to 125.

My Health Goals Are...(Required)

Weight Management

Brain Health

Heart Health

Stress Management

Healthy Immunity

Cold and Flu

Seasonal Flu

Healthy Digestion

Healthy Joints

Gut Health

Concentration

Panic Feelings

Cognition

Aches and Pains

Daily Soreness

Quality Sleep

Fitness

Healthy Aging

Feeling Energy

Acne

Skin Care

Exercise

Little or no exercise

Light exercise (1 times per week)

Moderate exercise (2-3 times per week)

Intense exercise (3+ times a week)

Activity

Sit at a desk all day

Stand walk now and again

On my feet and moving all day

Cardio training 2x a week or more

Flexibility (yoga) 2x a week or more

Strength (weightlifting)

Other

Weight

No matter what I eat I cannot gain weight

Weight is not an issue for me

I have to watch what I eat

I put on weight easily

Weight is an issue for me

Stress Level

It is HIGH

It is MEDIUM

It is LOW

Sleep

Great

Ok, I have trouble falling asleep

I don’t sleep long enough

Not well, I have trouble staying asleep

Cognitive Health

Excellent

Not bad

Good

Ok but at times I cannot focus well

Alcohol

Never

Monthly

2-4 times/month

2-3 times per week

4 or more times a week

I’d rather not say

Smoking Status

Daily

Occasional

Former

Never

I’d rather not say

Sunlight

I get at least 15 minutes of DIRECT sunlight everyday

I get LESS THAN 15 minutes of direct sunlight daily

Screen Time

I spend 3 hours or more, daily, looking at a screen

I spend less than 3 hours, daily, looking at a screen

Dietary Preferences (choose all that apply)

Caffeine Free

I eat kosher

I’ soy-free

Dairy free

Paleo diet

Vegan diet

Keto diet

Pescatarian diet

I’m a vegetarian

None of these

Servings of Colorful Vegetables

Less than 1

1

2

3 or more

Servings of Fruit

Less than 1

1

2

3 or more

Do you or your doctor have any health concerns we should know about?

Blood pressure

Cholesterol

Weight

Bone Health

Digestive Health

Blood Sugar

Joint Health

None of these

Are you concerned about a family history with any of these health conditions?

Heart disease

Diabetes

High Cholesterol

Osteoporosis

High Blood Pressure

None of these

Has your doctor recommended any of the following?

Iron

Probiotics

Multivitamin

Vitamin D

Omega 3

None of these

Do you take medications for any of the following?

Blood pressure lowering medication

Blood thinning medication

Type 2 diabetes medication

Cholesterol lowering medication

None of these

If you currently take supplements, why do you take them?

They help me meet my health goals ie healthy weight

They are mostly preventive

They help balance my diet

They are just part of my routine

They are for a specific health issue ie joint pain

Other reasons

I do not currently take supplements

Suggestions

Use the buttons below to see the product suggestions. PLEASE HIT THE SUBMIT BUTTON BEFORE YOU LEAVE!

Our assessment is indicating you would benefit from our ENERGY line of products. ENERGY products come in a tincture or a tablet. For more information or to order the product please click on the button below.

Energy Tincture

Energy Tablets

Our assessment is indicating you would benefit from our COMFORT line of products. COMFORT products come in a tincture or a tablet. For more information or to order the product please click on the button below.

Comfort Tincture

Comfort Tablets

Our assessment is indicating you would benefit from our REST line of products. REST products come in a tincture or a tablet. For more information or to order the product please click on the button below.

Rest Tincture

Rest Tablets

Our assessment is indicating you would benefit from our FOCUS line of products. FOCUS products come in a tincture or a tablet. For more information or to order the product please click on the button below.

Focus Tincture

Focus Tablets

Our assessment is indicating you would benefit from our DEFENDER line of products. DEFENDER products come in a tincture or a tablet. For more information or to order the product please click on the button below.

Defender Shot

Defender Tablets

Calm Tincture

Our assessment is indicating you would benefit from our GUT line of products. GUT products come in a tincture or a tablet. For more information or to order the product please click on the button below.

Gut Tincture

Gut Tablets

Our assessment is indicating you would benefit from our skin care line of products. For more information or to order the product please click on the button below.

Face Serum

Skin Defense

Name

This field is for validation purposes and should be left unchanged.

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