Step 1 of 5 — About You

You’re in — thank you.

Your health screening has been received. Peter and Tom will personally review your responses and be in touch within 24 hours.


Check your inbox — Tom will reach out directly from
contact@eternalwellness.center


Questions in the meantime? Reply directly to Tom’s email or reach us at contact@eternalwellness.center

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Pregnancy & Safety Protocol

At Eternal Wellness Center, we do not prescribe or manage peptide therapy during pregnancy or active breastfeeding due to clinical safety protocols.


We would love to support your recovery and optimization journey once you have finished breastfeeding. Please reach out to contact@eternalwellness.center if you have any questions.

Free Health Consultation

Let’s start with you.

The more you share, the better your protocol.

Peter reads every word of this before designing your protocol. The detail you provide here is the difference between a generic recommendation and one built specifically around you — your history, your biology, your goals.

This takes around 10 minutes. There is no obligation. Everything you share is strictly confidential.

Pharmaceutical-grade Specialist review Strictly confidential Free — no obligation
Your biological sex determines which health-specific questions appear throughout this form. This is for clinical accuracy only.
Goals & Lifestyle

What are you here to change?

Select everything relevant. The more specific you are, the better Peter can build your protocol.

Health Background

Your health history.

Peter reads every word of this before designing your protocol. Be specific — this is how contraindications get caught and how your protocol becomes personal.

This helps Peter avoid suggesting things you’ve already done. Select all that apply.
This helps Peter identify relevant interactions and ensure the protocol is appropriately supportive.

Allergies & Sensitivities

This section screens for potential adverse response risk. Please be as complete as possible — suspected sensitivities count even without a formal diagnosis.

Men’s Health Context

Your men’s health profile.

This is the layer that makes your protocol genuinely personal. James — our Men’s Health & Performance Specialist — reviews this directly before your protocol is designed.

Men’s Health Completion 0% complete
Hormonal Health & Testosterone

Have you noticed a significant drop in your drive, ambition, or competitive edge — the sense that you are operating below your normal level?

Has your mood become flatter, more emotionally detached, or less reactive to things that used to motivate or excite you?

Have you noticed increased irritability, reduced patience, or a lower threshold for frustration — out of character for you?

Do you find it harder to build or maintain muscle despite consistent training — or have you noticed unexplained muscle loss?

Are you accumulating fat primarily around your abdomen and chest — despite no significant change in diet or activity?

Have you experienced any breast tissue tenderness, puffiness, or sensitivity around the chest area?

Do you experience water retention — particularly in your face, hands, or around the waist — without a clear dietary cause?

Sexual Health & Function
This information is treated with complete clinical confidence. It is one of the most important indicators of hormonal and vascular health — and directly shapes your protocol.

Has your libido — your natural desire and interest in sex — decreased compared to earlier in your life or compared to 2–3 years ago?

Have you noticed a reduction in the frequency or firmness of morning erections?

Do you experience difficulty achieving or maintaining an erection — either occasionally or consistently?

Has your recovery time between sexual activity increased noticeably?

Performance & Recovery

Have your strength or endurance levels plateaued or declined — despite consistent training effort?

Does your body take significantly longer to recover from training sessions than it used to?

Do you carry unresolved or recurring injuries — particularly soft tissue, tendons, or joints — that are slow to heal?

Has your stamina or physical output during demanding tasks — exercise, physical work, sport — noticeably declined?

Do you wake up feeling unrestored after sleep — like your body did not recover overnight?

Has your overall physical capacity changed significantly in the last 2–3 years despite no major lifestyle change?

Cognitive Health & Drive

Do you experience brain fog — difficulty thinking clearly, poor word recall, or mental sluggishness — that is out of character for you?

Has your ability to focus on demanding cognitive tasks — strategy, problem-solving, complex decisions — declined?

Do you experience decision fatigue earlier in the day than you used to?

Has your drive to initiate things — projects, goals, social plans — dropped compared to your normal baseline?

Do you experience persistent mental fatigue that sleep does not resolve?

Sleep & Recovery Quality (GH Axis)

Do you struggle to fall asleep — lying awake for 20+ minutes despite feeling tired?

Do you wake during the night and have difficulty returning to sleep?

Do you wake earlier than intended and cannot get back to sleep?

Regardless of hours slept, do you wake feeling unrefreshed — never reaching deep, restorative sleep?

Have you been told you snore heavily, stop breathing during sleep, or have sleep apnoea?

Body Composition
Clinical Safety

Have you ever been diagnosed with or treated for prostate cancer, enlarged prostate (BPH), or elevated PSA?

Have you ever been diagnosed with or treated for testicular cancer or significant testicular issues?

Women's Health Context

Female physiological context.

Hormonal context fundamentally changes how we design and structure biological protocols. This helps us sync appropriately.

Women's Health Completion 0% complete
Health Screening

How is your body actually doing?

Answer as honestly as you can. If any area resonates, a few deeper questions will open automatically — the form responds to you. There are no right or wrong answers here.

No need to be clinical. Just tell us where you're at. This is the part Peter reads first.
Almost There

One last thing.

By submitting this form you confirm all information is accurate and consent to Eternal Wellness Center contacting you regarding your consultation. Your data is stored securely and never shared with third parties. Please also review our Medical Disclaimer.
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