IContext

A bit of context.

Who you are and how to reach you.

First Name

Last Name

Phone

For scheduling, should we proceed.

Where you are based

ii.

IISituation

Your current situation.

Just enough for us to understand who is applying.

Role & Industry

Founder, operator, investor, exited principal — whatever applies.

Age Range

Stage Most True to You

Actively building or scaling The work is intense and ongoing Established & operating The business is mature; you remain at the helm Transitioning or recently exited Considering or planning what is next Post-exit, focused on the next chapter The career outcome is settled; quality of life is the priority

iii.

IIIState

What is currently off.

Where the gap shows up most. Be specific.

Areas Currently Limiting You

Select all that apply.

Energy is inconsistent or insufficient Sleep is shallow or unrestorative Mind doesn't shut off; baseline stress is elevated Focus, clarity, or decision-making feels harder than it should Body composition or physical resilience has shifted Lab values are drifting in concerning directions Digestion, gut, or hormonal symptoms Long-term trajectory — concerned about the next decade

Elaborate Briefly

In your own words — what is most pressing? What feels different than it used to?

0 / 800

iv.

IVAmbition

What you want different.

If the work goes well, what changes — practically — in your life?

In Twelve Months

What would you want operating differently? Be specific where you can.

0 / 800

Have You Worked With Someone in This Space Before?

No — this would be the first Yes — concierge medicine, longevity, or functional medicine Extensively — multiple practitioners, ongoing

VFit

A final question on fit.

Engagements are private, ongoing, and structured. Each begins with a comprehensive baseline assessment, followed by a six-month minimum optimization period.

Readiness

Prepared to engage at this level if the fit is right Logistics and timing are not the constraint Exploring — want to understand more first Open to a conversation; not yet committed Possibly later, not currently Timing or other factors are a constraint right now

How Did You Find Beyond Healthy?

If a referral, by whom — so we can thank them.

Anything Else We Should Know

Optional. Anything that would help us understand your situation more clearly.

0 / 600

Your application has been received.

Each application is reviewed personally by Dr. Smith. If there is alignment, you will hear from us within two business days to arrange a private consultation.

— Beyond Healthy

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