Eligibility Questionnaire
Please answer honestly. Your responses help us determine if our treatment is right for you.
1: Do you experience decreased libido or sex drive?
2: Have you felt a drop in energy?
3: Do you experience difficulty sleeping?
4: Have you noticed softer erections or difficulty maintaining?
5: Have you experienced a decrease in strength & endurance?
1: Are you noticing mood changes, especially feeling sad, grumpy, or disinterest in things that you used to enjoy?
2: Have you lost height?
3: Have you experienced a deterioration in overall performance at work and life activities?
All information is encrypted and kept confidential.
