What are your current PCOS struggles *

Acne

Infertility

Weight Gain

Insomnia

Insulin Resistance

Dark skin patches

Hair Loss

Ovarian Cysts - OUCH!

Fatigue

What are your goals with PolyC's ? *

Conceive

Manage my symptoms, I want to be healthier

Weight Loss

Increase Libido! Yes! Yes! Yes!

Manage Insuline Resistance

What is your activity level ? *

I go a few times each week

I walk enough at work

I go to gym every week

How would you describe your activity level? *

Low activity - I sit at work and home

Medium - I walk often at work and home

High - I am active at work/home and attend the gym

How often is your menstrual cycle ? *

Regular - every 21-34 days

I go months without a cycle

Years! Years of cycle! Please help

I'm on birth control

What is your caffeine intake? *

Few sodas/coffee daily

One coffee/soda daily

No caffeine intake

Do you take other Rx?

Yes, I take birth control, Metformin, thyroid and blood pressure medicine

I take vitamins with inositol & D Chiro like Ovasitol

I take over the counter vitamins

How heavy is your bleeding during cycle? *

My cycle is light

normal, I change my pad/tampon every 3-4hours

Heavy, painful... and full of clots!

If you are trying to conceive, have you had any difficulties? *

No, I am not trying to conceive

Yes, we have tried for over years

Yes, I take fertility RX

Yes, but i had a miscarriage

Do you use ovulation test strips? *

Do you use ovulation test strips?

No, I am not ovulating

Yes, Often!

Do you have any concerns about the way your hair grows? *

No, I have a great complexion

Yes, I have hormonal acne

Yes, I have peach fuzzle

Yes, I have dark, Velvety skin patches

First Name *

Phone *

Email *

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