Averion Health | Begin Your Assessment

Step 1 of 5 — Let's Get Started

First, tell us
about yourself.

Takes about 3 minutes. Everything you share is private and HIPAA-protected.

First Name *

Please enter your first name.

Last Name *

Please enter your last name.

Email Address *

Please enter a valid email.

Phone Number *

Please enter your phone number.

Age *

Please select your age range.

State of Residence *

Currently serving 35 states — select your state to confirm availability.

Please select your state.

Step 2 of 5 — Qualifying Questions

Tell us about
your work.

Averion is exclusively for founders and executives. These questions confirm fit.

Which best describes your role? *

Founder / Co-Founder

CEO / President

C-Suite Executive (COO, CFO, CTO, etc.)

VP / Senior Director

Other High-Level Operator

Annual Personal Income *

Under $250K

$250K – $500K

$500K – $1M

$1M+

Step 3 of 5 — Your Symptoms

What are you
experiencing?

Select all that apply. Helps your provider know where to focus first.

Current Symptoms * (select all that apply)

Low energy / fatigue throughout the day

Crashes after meals, struggling to sustain output

Brain fog / reduced mental clarity

Difficulty thinking sharply, slower recall

Reduced focus and concentration

Can't lock in the way you used to

Declining output and execution

Operating below your potential

Poor sleep quality or insomnia

Not recovering even when you sleep enough

Mood changes / increased irritability

Shorter fuse, lower tolerance for stress

Low motivation or drive

The urgency and ambition feel muted

Physical decline (weight, recovery, strength)

Body not bouncing back like it used to

How long have you been experiencing this? *

Less than 6 months

6 months – 1 year

1–3 years

More than 3 years

Step 4 of 5 — History & Goals

What have you
already tried?

Helps your provider avoid recommending things you've already tested.

Have you tried any of the following? (select all that apply)

Supplements / vitamins stack

Therapy or mental health support

Hormone therapy (TRT / HRT)

NAD+ therapy

Biohacking protocols (sauna, cold plunge, red light, etc.)

Nothing — starting from scratch

Primary goal for this program *

Restore energy and eliminate crashes

Reclaim focus and mental clarity

Peak performance and output at work

Hormonal optimization (HRT / TRT)

All of the above — full optimization

Step 5 of 5 — Almost Done

Last few
questions.

Helps your provider prioritize your case and get you moving fast.

How much are these symptoms affecting your work output? *

1 — Minor impact10 — Severe

How are you planning to cover the program? *

Pay in full — $2,999 upfront

3 monthly payments — $1,205/month

FSA / HSA account

Not sure yet — want to learn more first

Anything else your provider should know? (optional)

First, tell us
about yourself.

Tell us about
your work.

What are you
experiencing?

What have you
already tried?

Last few
questions.

Assessment
Received.

What happens next

Not Quite a Fit Yet

First, tell usabout yourself.

Tell us aboutyour work.

What are youexperiencing?

What have youalready tried?

Last fewquestions.

AssessmentReceived.

What happens next

Not Quite a Fit Yet

First, tell us
about yourself.

Tell us about
your work.

What are you
experiencing?

What have you
already tried?

Last few
questions.

Assessment
Received.