Men's BHRT Evaluation Form

From a clinical management point of view, it is very useful to gain a detailed history of possible hormone deficiencies. All information provided will be kept confidential. After you fill out this evaluation a pharmacy representative with contact you within 72 hours to set up a consultation time with one of our pharmacist consultants at our Taylor Street location. There is an initial consultation fee of $150.00, payable at time of visit. The time allowed for an initial consult is 60 minutes. Follow up consultations will be billed according to time allowed. Please see office policies for more details. Complete the below evaluation to get started.