Katarina Damrée
Part 1 of your ROOTED prep

Your intake form

I'm so happy you're here. This form helps me get to know you properly before we meet, so our 90 minutes can go straight to what matters most to you.

It takes about 20 minutes. There are no right or wrong answers, short notes are perfect, and you can skip anything you're not sure about. Your answers save on this phone or computer as you go, so you can do it in a few sittings. Please finish it on the same device you started on, because your answers don't move between devices.

Everything you share is confidential and only used to prepare your ROOTED session. Looking for your blood upload or food diary? See all three things to send me.

Your answers save on this device as you go, so you can stop and come back any time. Just finish on the same phone or computer you started on.

Step 1 of 10

About you

Which country do you live in?

Your answers save on this device as you go, so you can stop and come back any time. Just finish on the same phone or computer you started on.

Step 2 of 10

Your priorities

Let's start with what matters most to you right now.

Are you working with a GP, specialist or other practitioner at the moment?

Your answers save on this device as you go, so you can stop and come back any time. Just finish on the same phone or computer you started on.

Step 3 of 10

Your health history

The basics, so I can see the whole picture. A few words is plenty.

What medications are you taking now?

One per line. Fill in whatever you know.

What supplements are you taking now?

One per line. Fill in whatever you know, or skip the typing and upload photos of the labels below.

Photos of your supplement labels (optional)

Your answers save on this device as you go, so you can stop and come back any time. Just finish on the same phone or computer you started on.

Step 4 of 10

Family health history

Whatever you know and are happy to share is perfect, and it's fine to leave anything blank.

Things like heart disease, high blood pressure, type 2 diabetes, cancer, osteoporosis, thyroid or autoimmune conditions, dementia, mental health, or early menopause.

Your answers save on this device as you go, so you can stop and come back any time. Just finish on the same phone or computer you started on.

Step 5 of 10

Women's health

Your cycle and symptoms tell me a lot about what your hormones are up to.

How are your periods at the moment?
Have you noticed any changes? Tick any that apply.
Hormonal contraception: now or in the past?
Hormone replacement therapy (HRT): now or in the past?
How much is each of these bothering you lately?

Skip any you're not sure about.

Hot flushes
Night sweats
Trouble falling asleep
Waking in the night
Tiredness
Brain fog
Low mood
Anxiety
Irritability or mood swings
Joint aches
Headaches or migraines
Bloating
Weight gain around the middle
Heavy periods
Breast tenderness
Low libido
Vaginal dryness
Heart palpitations
Hair thinning
Dry or itchy skin
Cravings

Your answers save on this device as you go, so you can stop and come back any time. Just finish on the same phone or computer you started on.

Step 6 of 10

Your digestion

Your gut has a big say in your energy, mood and hormones, so I'd love to know how it's doing.

Have you dealt with digestive issues in the past?
Do you often get any of these?
How often do you usually go?
Which of these looks most like your usual poo?

It sounds funny, but it tells me a lot about your digestion. This is the Bristol Stool Chart, used by doctors everywhere. If it changes a lot, tick all that apply.

Your answers save on this device as you go, so you can stop and come back any time. Just finish on the same phone or computer you started on.

Step 7 of 10

Sleep, stress and movement

The foundations that shape how you feel every day.

How well do you sleep, most nights?
How often do you wake in the night?
What usually wakes you? Tick any that apply.
How do you usually feel when you wake up?
How stressed do you feel, most days?

So I never suggest something you already know isn't for you.

What movement do you do? Tick all that apply.
How much time do you spend outside on a typical day?
How often do you wear sunscreen?
Do you smoke or vape?
Do you use any recreational drugs, including cannabis or CBD?

Totally optional. There's no judgement here, it just helps me understand your sleep, mood and energy.

Your answers save on this device as you go, so you can stop and come back any time. Just finish on the same phone or computer you started on.

Step 8 of 10

Food and drink

How food and drink fit into your everyday life.

How would you describe the way you eat?
How often do you cook at home?

So I never suggest recipes that won't work for your household.

How often do you eat out or get takeaway?
Where do you usually shop for groceries?
When do you usually eat?

Add a rough time for the ones you usually have, and leave the rest blank.

Do you ever skip meals?

Your drinks

Which water do you usually drink?

I love hearing these.

Your answers save on this device as you go, so you can stop and come back any time. Just finish on the same phone or computer you started on.

Step 9 of 10

Your dosha quiz

Part of your ROOTED Roadmap.

Doshas come from Ayurveda, India's traditional system of wellbeing, which is thousands of years old. It sees everyone as a unique mix of three energies, or doshas: Vata, Pitta and Kapha.

Your mix often reflects your natural build, personality, habits and preferences, from how you sleep to how you handle stress. It also gives clues about what might be out of balance, and simple ways to rebalance it. It's a lovely extra layer alongside your bloods and everything else you've shared, and I'll explain your results when we meet.

How it works: think about how you've been for most of your life, or as a child, rather than just lately. In each row, tap the one that's most like you first, then the one that's next most like you. The last one fills in by itself. Tap again to start a row over.

1 · Frame

2 · Weight

3 · Eyes

4 · Complexion

5 · Hair

6 · Joints

7 · Sleep pattern

8 · Body temperature

9 · Temperament

10 · Under stress

0Vata
0Pitta
0Kapha

Your answers save on this device as you go, so you can stop and come back any time. Just finish on the same phone or computer you started on.

Step 10 of 10

Almost done

Your answers save on this device as you go, so you can stop and come back any time. Just finish on the same phone or computer you started on.