IMPORTANT: Take a moment to add email@example.com to your contact list so they don't land in your junk folder.
You have already made a great decision to let our medical doctors review your blood work to see if you are a candidate for our hormone replacement program.
Now we just need a bit more information about your medical history and some disclosures for you to review.
Download the PDF document below and take a moment to fill out the medical history form and return it to us by using one of the following methods below:
Just a note: If you forget to download this paperwork now or simply can't find it again, then don't worry. We sent you an additional email with the same information above so you can't lose it.
Disclaimer: You will be charged for the evaluation fee of your blood lab work to qualify for the hormone replacement program. $99 is for initial bloodwork only; Payment will only be refunded if bloodwork is not completed and we can cancel the blood requisition.