Find out if you might be suffering from a hormonal imbalance
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What gender are you?
Yes
No
How has your energy level been lately?
Yes
No
How often do you exercise?
Daily
2-3 times a week
Rarely
Do you find it hard to gain or keep muscle mass?
Yes
No
Have you found it difficult to lose weight?
Yes
No
Are you experiencing hot flashes? *
Yes
No
Do you forget why you came into a room or where you put something?
Yes
No
Are you pleased with your sex drive?
Yes
No
Do you feel as though you get enough restful sleep at night?
Yes
No
Are you experiencing night sweats?
Yes
No
What age bracket are you in?
18-34
35-44
45-54
55-64
65 or above
Do you experience anxiety?
Yes, Please Text/Call Me
No, Thank you
How did you hear about us?
Who can we thank for your referral?