OSG Client Intake — Optimum Standard Group

Section 01

About You

Full name

Email address

Phone number

Age

Biological sex

Occupation / Industry Helps us understand your schedule and demands

How did you hear about Optimum Standard Group?

Section 02

Your Goals

Describe your #1 goal in your own words Be specific — what does success look like to you 90 days from now?

What has held you back from reaching this goal so far?

Section 03

Health Baseline

Current height

Current weight

Do you have any diagnosed medical conditions? This is for protocol safety only — all information is confidential

Current medications or supplements

Have you had bloodwork or labs done in the last 12 months?

Yes — I have results Yes — but I don't have them handy No — not recently Never had labs done

If yes — what panels were run? e.g. CBC, metabolic panel, testosterone, thyroid, cortisol, etc.

Section 04

Lifestyle & Daily Habits

Current exercise routine

None currently 1–2x per week 3–4x per week 5+ days per week

Describe your current diet approach No judgment — just be honest

Rate your average sleep quality 1 = terrible / 10 = excellent

Poor Excellent 5

Rate your current daily energy levels 1 = exhausted all day / 10 = consistently high energy

Low High 5

Rate your current stress levels 1 = very low / 10 = extremely high

Low High 5

Alcohol consumption

None Occasional (1–2x/month) Social (weekends) Regular (several times/week)

Section 05

Previous Optimization Experience

Have you worked with a coach, consultant, or functional medicine doctor before?

Yes — positive experience Yes — mixed results Yes — not helpful No — this is my first time

What protocols, programs, or products have you already tried? What worked? What didn't?

How familiar are you with peptides, biomarker testing, or advanced wellness protocols?

Completely new to this Basic awareness Moderate knowledge Fairly advanced

Section 06

Logistics & Expectations

Which package are you most interested in?

Intake + Roadmap ($497) Optimization Sprint ($1,497) VIP Day ($2,500) Not sure yet

How soon are you looking to start?

Immediately Within 2 weeks Within a month Just exploring for now

Do you have any questions or anything else you want us to know before your call?