Do you think your GlycanAge results will be:

Question(s) this replaces or relates to:
How would you rate your overall health?

What is your main goal/objective for discovering your biological age through GlycanAge?


(Think about adding more options)
Question(s) this replaces or relates to:
What is your main goal/objective for discovering your biological age through GlycanAge?

How tall are you and how much do you weigh?

Height:    Weight:
Question(s) this replaces or relates to:
What is your height?
How much do you weigh?

How would you describe your occupation in the past year?

My work includes physical activity. I feel stress at work.
Question(s) this replaces or relates to:
What is your present occupation? (or the one you've invested most time in past year)

How is your sleep?

Question(s) this replaces or relates to:
About how many hours sleep do you get in every 24 hours during the working week?
How would you describe your sleep quality over the last month?

Do you exercise?

Question(s) this replaces or relates to:
How many times do you exercise (at least 30 min) per week?

How would you describe your workouts?

I usually do my workouts at intensity for minutes and I focus on exercises.
Question(s) this replaces or relates to:
What type of exercise do you generally tend to do?
What is an average length of your exercise per session (in minutes)?
What is the intensity of your exercise?

What is your diet like?

Question(s) this replaces or relates to:
When do you snack?
Do you eat out or order food in?
If so, how many times per week?

Do you skip any meals?

Question(s) this replaces or relates to:
Do you fast? If so, how often?
Which meals do you regularly eat? Tick those that apply:

Tell us more about your lifestyle and diet. Select all that apply:

Which of these foods do you eat on a weekly basis?


How is your food usually prepared?


Tell us more about you lifestyle habits?
Question(s) this replaces or relates to:
What is your average daily water intake? Do you drink filtered or tap water?
How many times each day do you have the following food items?
How is your food usually prepared? Check all that apply.
Diet type?
Do you follow a special diet?
Do you drink alcohol? If so, how many units a week?
Do you smoke? If so, how many cigarettes a day?
Have you been a smoker previously? If yes, how many years?

List any medications or dietary supplements you've been taking:


(Think about adding tags instead of freeform text)
Question(s) this replaces or relates to:
Are you or have you been taking any medications/supplements? Please, list anything you take regularly including GP prescribed medication, self -prescribed medication, nutritional supplements, herbal or homeopathic remedies.

How is your mood/energy?

Question(s) this replaces or relates to:
How would you rate your general feeling of well being during the last week?

Please tell us about any existing conditions.


(Think about adding tags instead of freeform text)
Question(s) this replaces or relates to:
Do you or have you ever suffered from a chronic disease/condition? If so, please specify?
Do you have any health concerns or symptoms outside of this questionnaire? Please, list them here:

Do you have a family history of disease or allergies?


(Think about adding tags instead of freeform text)
Question(s) this replaces or relates to:
Do you have a family history of disease or allergies? (e.g. heart disease, diabetes, asthma, etc.). Please, state disease, age of onset and gender.

Select any symptoms that you've experienced in the past X months:

Body


Mind


Emotions
Question(s) this replaces or relates to:
Body (Digestive Questions; Eyes / Eyesight; Ears / Hearing; Lungs; Energy / Activity; Head; Mouth / Throat;)
Emotions
Mind
Are you experiencing any of the below symptoms (female)

Have you suffered from any acute inflammation in the six weeks prior to your sample?

Question(s) this replaces or relates to:
How many days did you spend in hospital in total in the last year? (Put zero (0) if you haven't been to a hospital last year)

Please select any that apply to you:

(Female only)
Question(s) this replaces or relates to:
Day of menstrual cycle (if applicable)* The 1st day of the menstrual cycle is the 1st day of your menstrual period.
Is your menstrual cycle regular?
What contraceptives do you use if any?
Are you pregnant? If so, how many weeks?
Are you currently breastfeeding?
Are you menopausal or perimenopausal? If so, how long for?
Have you gone into menopause naturally or via medical procedure?
Are you currently taking hormone replacement therapy? If yes, please list what type and the dose you are currently on and for how long.
Do you or have you ever suffered from PCOS, fibroids, endometriosis. Please, specify.