How often do you experience bloating, and when does it typically occur?Select oneDaily - After most mealsDaily - Gets worse throughout the dayFrequently - 3-4 times a weekOccasionally - Only with specific foodsRarely - Around menstrual cycle onlyAlmost never
Describe your bowel movements over the past monthSelect oneDaily - Formed and easy to passDaily - Loose or unformedEvery few days - Constipated/HardIrregular - Alternating loose and hardMultiple times a day - Urgent
Do you experience any of the following digestive symptoms regularly?Select all that applyExcessive gasAbdominal crampingAcid reflux / HeartburnNauseaKnown food sensitivitiesUrgent bowel movementsNone of the above
Have you noticed connections between your digestive symptoms and:Select all that applySpecific foods (Dairy, Gluten, etc.)High stress levelsMenstrual cycle phasesPoor sleepTravel or routine changesNo obvious connections
How would you rate your overall energy levels and their relationship to what you eat?Select oneHigh energy - Food fuels me wellModerate energy - Occasional slumpsLow energy - Often feel sluggish after eatingVariable - Certain foods cause energy crashesChronically fatigued regardless of diet
Are you currently taking any supplements, probiotics, or medications for digestion?Select all that applyProbiotics / PrebioticsDigestive EnzymesFiber supplementsLaxatives or stool softenersAcid reducers (PPIs, Tums)Antibiotics (currently or recently)None