HRT Quiz for Men
Name
Email
Phone
Do you have a decrease in libido (sex drive)?
Yes
No
Do you have a lack of energy or experience unexplained fatigue?
Yes
No
Do you have a decrease in strength and/ or endurance?
Yes
No
Have you lost height?
Yes
No
Have you noticed a decreased “enjoyment of life” ?
Yes
No
Are you sad and/or grumpy?
Yes
No
Are your erections less strong?
Yes
No
Have you noticed a recent deterioration in your work performance?
Yes
No
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