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    A NuShape Personal Protocol · Intake
    Step 1 of 6 — About you 0%
    A NuShape Personal Protocol

    Tell me about yourself.

    Make yourself a cup of something and give this half an hour or so. I'd rather you took your time than rushed it.

    Everything I write for you comes from what you tell me here — your daily rhythm, your smoothie recipes, the supplements I'd suggest, the way your four weeks unfold. You can tell me the messy version, not the tidy one. There's no judgement here, and the more honest your answers, the better your protocol will be.

    Your answers save as you go, on this device. Close the tab, come back tomorrow, pick up where you left off — it'll all still be here.

    — Jessica
    Section 01

    About you

    Let’s start with the basics — these ones I do need from everybody.

    City, country.

    Sex assigned at birth
    Age range
    How would you describe your life stage right now?

    Choose up to three.

    up to 3
    Caregiving load in detail

    Anything significant you'd want me to know about — heart disease, autoimmune conditions, cancer, hormonal patterns, mental health history, exceptional longevity. Not for diagnosis — for understanding what your body may be predisposed to.

    Section 02

    Your daily rhythm

    How your day actually looks — not how it should look.

    What does your work look like?
    Average daily screen time
    Do you sit, stand, or move during work?
    What time of day do you typically fall apart energetically?
    How would you describe your current stress level?
    Where does your stress live in your body most?
    Travel patterns
    A few of the required fields above need a moment — please scroll up and fill those in to continue.
    Save and return later
    Section 03

    How your body feels right now

    Every scale below runs the same direction: 1 means it isn’t a problem for you. 10 means it’s a daily struggle. A low number is good news. Be honest — the ones you’d rather not admit to are the ones that shape your protocol most.

    1 · energy is great10 · exhausted every day
    1 · I sleep well10 · severe nightly struggle
    1 · comfortable10 · daily discomfort
    1 · skin is happy10 · constant concern
    1 · happy with where I am10 · not happy at all
    1 · no pain10 · constant pain
    1 · sharp and clear10 · foggy every day
    1 · calm and settled10 · anxious every day
    1 · no symptoms10 · severe daily symptoms
    1 · none10 · constant
    1 · steady10 · highly volatile
    Section 04

    Mental health & emotional context

    Optional but valuable. The protocol changes meaningfully based on what's underneath the symptoms.

    Anxiety pattern
    Have you experienced burnout before?
    Are you currently working with a therapist, counselor, or coach?
    Have you experienced significant grief or loss in the last 24 months?
    Would you describe yourself as a sensitive nervous system?

    Sensitive to stimulation, noise, bright light, large groups, caffeine, etc.

    Your relationship to your body right now
    A few of the required fields above need a moment — please scroll up and fill those in to continue.
    Save and return later
    Section 05

    Hormonal & reproductive

    Female biology is too specific to ignore. These answers shape your protocol significantly.

    Where are you in your hormonal life?
    Cycle length and regularity
    Symptoms you experience around your cycle, perimenopause, or menopause
    Are your symptoms improving, stable, or worsening over the last 12 months?
    Do you track your cycle?
    Section 05

    Hormonal & reproductive

    Male hormonal health shifts the protocol meaningfully. These answers help me calibrate.

    How is your testosterone and male hormonal health?
    Symptoms you experience around hormonal health
    Have you had testosterone tested in the last 24 months?
    Section 05

    Hormonal & reproductive

    Tell me about your hormonal life in your own words — whatever feels relevant for shaping your protocol.

    Anything about your hormonal life, history, current treatments, or specific patterns you'd like the protocol to honor.

    A required field above is still empty — please complete it to continue.
    Save and return later
    Section 06

    Your goals, concerns & questions

    What do you want from these 30 days — and what's actually been on your mind?

    Top 3 priorities for your protocol

    Choose up to three.

    up to 3

    The thing that's been on your mind. The symptom that won't resolve. The pattern you're worried about. Anything that feels like it deserves a careful answer.

    Things you've read conflicting advice about. Examples: whether fasting is helping you, whether you should be on HRT, whether your supplement stack is doing anything, whether your training is right for your stage of life.

    The thing you'd actually want to know. Don't filter for whether it's the "right" question to ask. Ask the real one.

    Section 07

    Nutrition, supplements & food relationship

    How you actually eat, what you supplement with, and what makes a recipe work for you.

    How would you describe your current way of eating?
    Coffee — how much daily?
    Your relationship to coffee
    What do you tend to crave?
    When during the day do you fall apart nutritionally?
    What happens when you skip meals?

    What you would not give up. Coffee, wine, chocolate, cheese, etc.

    Alcohol — typical weekly intake
    Do you currently practice any form of fasting or time-restricted eating?
    How do you feel about supplements in general?
    Realistic monthly supplement budget

    Things that gave you anxiety, disrupted sleep, made gut worse, etc. Examples: ashwagandha, certain probiotics, methylated B-vitamins, etc.

    Pill capacity
    Any sensitivities that affect what you can take?

    Or — what do you skip and replace with coffee? Either is useful.

    Cooking and prep reality
    Kitchen equipment you have
    Flavor preferences for your smoothies and drinks
    Texture preferences
    A few of the required fields above need a moment — please scroll up and fill those in to continue.
    Save and return later
    Section 08

    Movement

    Movement shapes everything else.

    Current movement practice
    What kind of movement do you actually enjoy?
    Do you walk after meals?
    Section 09

    Sleep in detail

    Sleep is the foundation of every protocol.

    How long does it typically take you to fall asleep?
    Do you wake during the night?
    Do you remember your dreams?
    What's in your bedroom right now?
    Your bedroom temperature at night
    What do you wear to bed?
    Have you tried any sleep tracking?
    Section 10

    Your light environment

    Light is upstream of almost everything we'll work on.

    How much natural morning light do you typically get in the first hour of waking?
    Do you wear sunglasses regularly?
    Your evening light environment
    What's your home environment generally like?
    Does your mood or energy shift with the seasons?
    A few of the required fields above need a moment — please scroll up and fill those in to continue.
    Save and return later
    Section 11

    NuShape devices & current protocols

    Optional. If you already own NuShape devices, your protocol will tell you exactly how to use them.

    Do you currently own any NuShape or Cellf devices?
    Which devices?
    Are you using them consistently right now?
    Section 12

    Health considerations

    Important for your safety. All information is private and used only to make sure your protocol is appropriate for your specific situation.

    Are any of the following currently true for you?

    Check all that apply.

    Section 12B

    Recent lab work

    Optional, but the more specific you can be, the more useful your protocol becomes. Skip if you haven't had labs or prefer not to share.

    Have you had blood work or lab testing in the last 12 months?

    Number, then unit.

    TSH, free T4, free T3, reverse T3, antibodies — whatever you have. Just type the numbers and labels you remember or can quickly find.

    Estradiol, progesterone, testosterone, DHEA, cortisol — whichever apply to you. Numbers and units if you have them.

    Examples: hs-CRP, homocysteine, fasting glucose, HbA1c, fasting insulin, ferritin, omega-3 index. Whatever's been tested.

    The number that came back unexpected. The level your doctor said was "fine" but you're not sure. The thing nobody has explained to you yet.

    A few of the required fields above need a moment — please scroll up and fill those in to continue.
    Save and return later
    Almost there

    Thank you, —.

    You've just done meaningful work. Take a breath before you submit — you can still go back and adjust anything that feels unfinished.

    When you're ready, your intake comes to me directly. I'll review every answer myself and your Personal Protocol arrives in your inbox within 72 hours. It will include your daily rhythm, your supplement and breathwork prescriptions, your custom smoothie recipes, the device guidance most relevant to your specific biology, answers to your specific questions and lab observations, and the other elements I match to your archetype and your specific answers.

    A few days later, your follow-up emails begin — fourteen of them over four weeks, taking you through the protocol one piece at a time.

    — Jessica

    You've told me a lot here, so let me be straightforward about where it goes. Your answers are delivered to me by our form provider, Formspree, and arrive in my email inbox. I read every intake myself. I draft your protocol with the help of an AI writing assistant working from your answers, and I personally review, correct and sign off on every word before it reaches you — nothing is sent to you that I haven't read. Your intake is never sold, never shared with advertisers, and never used to market to you beyond your own protocol and its follow-up emails. You can ask me to send you a copy of your intake or delete it entirely at any time, and I'll do it — bodysoulandbeauty@gmail.com. One thing that matters: this is wellness coaching and education, not medical care. It doesn't diagnose or treat anything, and it isn't a substitute for your doctor. If something here is urgent, please speak to a clinician rather than waiting 72 hours for me.

    Your protocol arrives within 72 hours. Your four weeks of follow-up begin just after.

    Received

    Thank you, —.

    Your intake is in. I'll review it personally and your Personal Protocol will arrive in your inbox within 72 hours.

    In the meantime, breathe. You've already done the hardest part — being honest about where you are.

    — Jessica
    NuShape · Personal Protocol · Intake form
     

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