TRT Pre-Bloodwork Health Screening

Step 1 of 12

What is your name?

First Last

What is the best number to reach you?

What is your email address?

What is your state of residence?

What is your gender at birth?

Male

Female

Next we will ask you about the symptoms you are experiencing.

Physical Symptoms

Fatigue: Feeling unusually tired or low in energy.

Decreased muscle mass: Difficulty gaining or maintaining muscle, despite regular exercise.

Increased body fat: Especially in the abdominal area.

Loss of bone mass: Increased risk of osteoporosis or bone fractures.

Reduced endurance: Poor performance during physical activities.

Hair loss: Thinning or loss of body and facial hair.

Hot flashes: Periodic sensations of heat and sweating, though less common in men.

Please select the symptoms you are experiencing.

Sexual Symptoms

Low libido: Decreased sexual desire.

Erectile dysfunction: Difficulty getting or maintaining an erection.

Reduced semen volume: Less ejaculate during orgasm.

Infertility: Lower sperm production, leading to fertility issues.

Please select all the symptoms you are experiencing.

Emotional and Cognitive Symptoms

Mood changes: Increased irritability, depression, or anxiety.

Difficulty concentrating: Cognitive fog or trouble focusing.

Lack of motivation: Less enthusiasm for things that used to be enjoyable.

Please select all the symptoms you are experiencing.

Other Possible Symptoms

Sleep disturbances: Trouble sleeping or staying asleep, often related to other symptoms like low energy or mood changes.

Gynecomastia: Development of breast tissue in men.

Please select all the symptoms you are experiencing.