Testing Request

Medical history

Have you ever been diagnosed with prostate cancer?

Did you undergo treatment for prostate cancer?

Do you have kidney disease?

Have you ever been diagnosed with breast cancer?

Do you have uncontrolled or poorly controlled heart failure?

Are you currently on testosterone replacement therapy (TRT) or have recently been on TRT within past 3 months?

Are you currently or have you recently been on ather anabolic steroid like testosterone?

Are you currently, or within the past 60 days, taking opioid pain medications (like hydrocodone,oxycodone, buprerphine,morphine, etc.) OR glucocorticoid type meds (like prednisone,cortisone, dexamethasone, etc) on a frequent, long term basis.

Are you having any of the following signs and symptoms consistent with low testosterone.

Check each below if present:


Weight Gain

Loss of muscle and strength

Erectile dysfunction

Poor focus

Low sex drive

Loss of drive/motivation

Low or “blah mood”

Increased irritability

Hot flushes/sweats

Less physical stamina

Less hair growth

sign name below

Start trt now!