ASSESSMENT

HORMONE HEALTH ASSESSMENT

Take this brief survey. If you have a cumulative score of 5 or higher, we can connect to discuss some options for better hormone health.

This section for both women and men.*

	Never (0)	Mild (1)	Moderate (2)	Severe (3)
Fatigue
Mood changes: Irritability (+/-), anxiety, nervousness, depression
Decreased mental ability: Memory loss, confusion, loss of focus
More sweating than normal
Weight gain
Decreased sex drive
Sleep problems
Decreased muscle strength
Hair loss/breakage
Joint pain, muscle aches

This section for WOMEN ONLY.
Never Mild Moderate Severe
Hot flashes, night sweats
Vaginal dryness
Dry, wrinkled skin
If your score is 5 or higher, would you like to schedule an appointment?
- Yes
- No
(To schedule an appointment, be sure to enter your contact info below.)
Name (req'd for followup)
First Last
Email (req'd for followup)
Phone (req'd for followup)

88461

CENTRAL AUSTIN

LAKEWAY

BEE CAVE

We specialize in regenerative medicine, focusing on aging gracefully and a high-quality life.

(Next to Vik Medical)
1518 RR 620 Building H, Suite 100
Lakeway, TX 78734 (map)

Mon: 8am to 5pm
Wed: 8am to 12pm
Thu: 8am to 5pm

(New location as of May 1, 2021)
2906 Medical Arts Street
Austin, TX, 78705 (map)

Tue: 8am to 5pm
Wed: 1pm to 8pm
Fri: 8am to 5pm

Visit our Contact Us page to complete a short form and connect with us.