Signa Peptides
Health Screening Questionnaire
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Required blood test panels

The exact panel your practitioner needs before your consultation can be reviewed. Take this to your GP, endocrinologist, or private lab, in either order relative to this questionnaire. Men and women are listed separately, since the hormone markers differ.

Required Blood Test
Elite Optimisation Panel · Male
Recommended for executives, athletes, longevity clients and anyone seeking the most comprehensive assessment before commencing peptide therapy.
Haematology
Complete Blood Count (CBC / FBC)
Metabolic health
Fasting glucose Fasting insulin HbA1c
Lipid profile
Total cholesterol HDL cholesterol LDL cholesterol Triglycerides Apolipoprotein B (ApoB) Lipoprotein(a)
Liver function
AST ALT GGT Alkaline phosphatase (ALP) Total bilirubin Albumin
Kidney function
Creatinine eGFR Urea Sodium Potassium Chloride Uric acid
Inflammation
hs-CRP ESR
Thyroid function
TSH Free T4 Free T3 Anti-TPO Anti-thyroglobulin (Anti-Tg)
Growth hormone axis
IGF-1
Male hormone panel
Total testosterone Free testosterone SHBG LH FSH Sensitive estradiol (E2) Prolactin DHEA-S Morning cortisol (07:00–09:00) PSA (40+)
Iron status
Ferritin Serum iron TIBC Transferrin saturation
Vitamins & micronutrients
Vitamin D (25-OH) Vitamin B12 Folate Magnesium (RBC, or serum if unavailable)
Cardiovascular & longevity
Homocysteine
Patient preparation
  • Fast for 12 hours (water only)
  • Attend the laboratory between 07:00–09:00
  • Avoid resistance training and cardiovascular exercise for 24 hours beforehand
  • Avoid alcohol for 48 hours beforehand
  • Remain well hydrated
  • Continue prescribed medications unless your healthcare professional advises otherwise
Clinical purpose

This panel assesses eligibility and safety before peptide therapy, identifies metabolic, endocrine and inflammatory barriers to performance, recovery and body composition, evaluates cardiovascular risk beyond a standard lipid profile, detects iron, vitamin and mineral deficiencies that may impair response to peptide therapy, and establishes a comprehensive baseline for monitoring treatment efficacy and long-term optimisation.

Recommended repeat testing: every 6 months, or every 3 months during active peptide protocols requiring closer monitoring.

Welcome

Your health,
understood completely.

This questionnaire forms the foundation of your Signa Peptide protocol. Every question matters: your answers determine which peptides are appropriate, which are contraindicated, and what your bloodwork needs to show before we begin.

Consultation fee

€150 one-time, covers your Peptide Protocol and Client Report in full

This is a complete, standalone deliverable: both are designed from this intake and your bloodwork, then talked through with you directly on a one-time 30-minute consultation call. Nothing further is charged today.

Peptide supply, and the ongoing oversight, re-testing, and adjustment a protocol needs once you're running it, are what our membership plans are for. These are shown once your consultation has been reviewed; choose to continue, and this €150 is credited toward your first membership payment.

Before you start, please read

This is a coaching and education consultation, not a medical consultation. All protocols produced from this questionnaire should be reviewed with your physician before implementation.

The questionnaire takes approximately 10–12 minutes to complete. Answer honestly, particularly regarding medical history. Information that seems minor to you can be clinically significant for protocol design.

Blood test: mandatory before we can proceed

A comprehensive blood panel is required before your consultation can be reviewed. Signa Peptide cannot design, approve, or dispense a protocol without it. You can complete it before or after this questionnaire, in either order, but your protocol review will not begin until your results are received.

The exact panel to take to your GP, endocrinologist, or private lab is available above, before or after you complete this questionnaire: a separate list for men and women, since the hormone markers differ, with the option to save it as a PDF. If you don't yet have a test booked, you can still submit this questionnaire and arrange it straight after.

What happens next

Once submitted, your questionnaire and bloodwork are reviewed by our practitioner team. Within 5 working days of your completed blood panel being received, your practitioner designs your Peptide Protocol, the phased timeline, dosing, and monitoring schedule itself, and prepares your Client Report, the written explanation of why it fits your results.

Both are talked through with you directly on your one-time 30-minute consultation call. If you decide to continue from there, with the peptides supplied and your protocol monitored and adjusted as your markers change, your practitioner will walk you through our membership plans on that same call.

Section 1 of 7

Personal
details

Basic information used to contextualise your results and protocol recommendations.

1 / 7
Section 2 of 7

Your goals &
priorities

Select everything that applies. There are no wrong answers. This helps us understand what outcomes matter most to you.

Primary goals
If you had to choose one thing this protocol must achieve, what would it be?
How long are you prepared to commit to a structured protocol?
2 / 7
Section 3 of 7

Medical
history

This section determines which peptides are safe for your specific profile. Please answer honestly: some conditions are absolute contraindications for certain agents.

Why this matters: Several peptides carry meaningful risk in individuals with specific conditions. GH-axis peptides require cancer risk assessment. Angiogenic peptides require thyroid nodule screening. This is not a formality. Your answers directly shape what is and is not included in your protocol.
Cancer & growth risk
Parents, siblings, or children
Cardiovascular & metabolic
Thyroid, hormonal & autoimmune
Other medical history
Relevant for neuroactive peptides (Selank, Semax, Cerebrolysin). These peptides require cautious use in psychiatric instability.
Relevant for tissue repair peptides (BPC-157, TB-500, GHK-Cu)
3 / 7
Section 4 of 7

Medications &
supplements

Drug and supplement interactions must be assessed before any peptide protocol is designed. Include everything, including over-the-counter medications.

Including aspirin, warfarin, rivaroxaban, apixaban, clopidogrel, or fish oil at high doses
List vitamins, minerals, protein supplements, pre-workouts, herbal supplements, etc.
4 / 7
Section 5 of 7

Lifestyle &
current health

Peptides amplify the response to training, nutrition, and recovery. They do not replace them. Understanding your current baseline helps us calibrate what is realistically achievable.

Training & activity
Nutrition
Sleep, stress & recovery
Very poorExcellent
Chronically exhaustedConsistently high
No stressSeverely stressed
5 / 7
Section 6 of 7

Your blood
test

A comprehensive blood panel is the foundation of a safe, effective peptide protocol. Below is the exact panel to take to your doctor or private lab: the Elite Optimisation Panel, split by sex since the hormone markers differ.

Mandatory before your consultation can proceed. Signa Peptide cannot design, approve, or dispense a protocol without this panel. Complete it before or after this questionnaire (either order is fine), but your protocol review will not begin until your results are received.

Opens the Elite Optimisation Panel for men and women, with the option to save it as a PDF to take to your lab.

↑
Click to upload or drag and drop
PDF, JPG, or PNG. Multiple files accepted
No blood test yet. No problem. Submit this questionnaire and arrange your blood draw using the panel above. Your protocol design begins once results are received. We recommend using a private lab if your GP does not cover the full panel. Typical turnaround is 3–5 working days.
Even older results can provide useful context for protocol design
↑
Upload previous blood tests
6 / 7
Section 7 of 7

Review &
submit

Almost done. Add any final information, confirm your details, and submit.

Context that did not fit elsewhere: previous protocol experiences, specific concerns, lifestyle constraints, etc.
Declarations
By submitting this questionnaire you confirm the above declarations. Signa Peptide reserves the right to decline a consultation or request additional information before proceeding. Your data is held in strict confidence and is never shared with third parties.
✓
Submitted

Questionnaire received.
We'll be in touch.

Thank you for completing your Signa Peptide health screening. Your questionnaire has been submitted and is being reviewed by our team.

Practitioner review status

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Send your report to your practitioner directly

Whether or not automatic saving worked above, you can also send your answers yourself right now, in two steps:

Downloads a plain-text summary of every answer you gave, then opens an email to protocols@signapeptide.com. Attach the downloaded file before sending.

What happens next

If you have uploaded blood results: You will receive your consultation report within 5 working days.

If your blood test is pending: Submit your results to protocols@signapeptide.com and your protocol will be designed within 5 working days of receipt.

If you have any questions in the meantime, contact us directly at the same address.