Men's Hormone Testing | Hormone Health Grand Junction

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(970) 812-5115

Men's Hormone Test

Men's Hormone Test

Take this test to help us assess how bioidentical hormone replacement might benefit you.

Last Name

First Name

Phone *

Email *

Do you feel depressed?

Do you feel depressed?
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No
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Have you noticed a loss of self-confidence?

Have you noticed a loss of self-confidence?
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No
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Do you have less interest in sex?

Do you have less interest in sex?
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No
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Do you have joint pain?

Do you have joint pain?
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No
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Have you noticed fewer morning erections or do you have trouble getting an erection?

Have you noticed fewer morning erections or do you have trouble getting an erection?
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No
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Do you find yourself having difficulty concentrating or focusing?

Do you find yourself having difficulty concentrating or focusing?
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No
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Have you noticed a loss of muscle mass, strength, or endurance?

Have you noticed a loss of muscle mass, strength, or endurance?
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Do you feel less energetic than when you were 30?

Do you feel less energetic than when you were 30?
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No
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Do you feel irritable, angry, or impatient without control of emotions?

Do you feel irritable, angry, or impatient without control of emotions?
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Do you have high blood pressure or cholesterol?

Do you have high blood pressure or cholesterol?
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What is your preferred method of contact?

phone
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How did you hear about us?

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I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

Men's Questionnaire

Men's Questionnaire

Please rate your symptoms between 0-10, with 0 indicating no symptoms and 10 indicating severe symptoms.

First Name

Last Name

Phone *

Email *

Progesterone Symptoms

Sleep Disturbances

Sleep Disturbances
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10
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Depression

Depression
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10
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List is empty.

Irritability

Irritability
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8
9
10
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Anxiety

Anxiety
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9
10
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Restless Legs Syndrome

Restless Legs Syndrome
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10
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Mood Swings

Mood Swings
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Migraine Headaches

Migraine Headaches
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Palpitations

Palpitations
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Estrogen Symptoms

Night Sweats

Night Sweats
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Hot Flashes

Hot Flashes
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Dry Skin

Dry Skin
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Testosterone Symptoms

Erectile Dysfunction

Erectile Dysfunction
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10
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Fatigue

Fatigue
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10
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Low Sex Drive

Low Sex Drive
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8
9
10
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Poor Focus

Poor Focus
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10
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Body & Joint Pain

Body & Joint Pain
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10
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Memory Lapses

Memory Lapses
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Low Exercise Tolerance

Low Exercise Tolerance
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Loss of Muscle Tone

Loss of Muscle Tone
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10
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Acne

Acne
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Hair Loss

Hair Loss
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How did you hear about us?

How did you hear about us?
TV
Online Search
Friend
Dr. Referred
Social Media
Online Ad
Other
No elements found. Consider changing the search query.
List is empty.

What is your preferred method of contact?

phone
email
No elements found. Consider changing the search query.
List is empty.

I agree to terms & conditions provided by the company as stated in the privacy policy at www.hhwoc.com. By providing my phone number, I agree to receive text messages from the business.

Address

1190 Bookcliff Avenue, Suite 202Grand Junction, CO 81501

Phone

(970) 812-5115

Monday - Thursday 8:00 am - 6:00 pm

Closed for lunch 12:00 pm - 1:00 pm