Fertility Pattern Intake (Clinician) Name Age Trying to conceive (how long) 0–3 months 3–6 months 6–12 months 12+ months 2 years+ Cycle regular? Regular Irregular Cold hands/feet? No Yes Night heat / sweats? No Mild Yes PMS severity None Mild Moderate Severe Blood color Bright red Dark red Brown Purple Pale pink Clots None Small Large Stringy Pre-period spotting? No Yes Ovulation pattern Regular Irregular Often absent Unknown Digestive pattern Normal Bloating Constipation Loose stools Alternating Sleep Good Light Insomnia Waking in night Stress level (0–10) Diagnosed conditions (PCOS, endo, fibroids, thyroid, etc.) Generate Pattern
