First Name:

Last Name:

Email Address:

Phone:

Hey
asd
,
Thanks for starting your online visit.

Here’s what will happen next:

 

1

Answer our brief questionnaire regarding your health symptoms. Our online visit should take no more than 5-10 minutes.

2

Your answers will be reviewed by our medical team and will determine whether you are a candidate for testosterone therapy.

3

Someone from our medical team will follow up with you to discuss your results and potential treatment plans.

The Easy Stuff

This basic information helps us determine if you are a candidate for testosterone therapy.

Sex

Birthdate:

Have you been on testosterone therapy before?


The important stuff

Please answer these questions as accurate as possible. This will help our doctors determine if you are eligible to take the next steps towards receiving testosterone therapy treatment.

Do you feel tired or rundown?

Does your sex drive feel as powerful as it used to be?

Is it hard for you to get up and get going in the morning?

Do you feel like you may be depressed?

Do you struggle to keep your weight, and specifically body fat, in a healthy range?

Is it hard for you to build or keep muscle?

Do you notice significant changes in your mood?

Are you challenged with falling asleep, or staying asleep?

Do you feel that your mind is not sharp and focused?

Great news! You are prequalified for the Express Test program. A patient coordinator will contact you shortly. In the meantime, click next to finish your account set up and get started.

You can also give us a call at 800-657-3394.