Women's BHRT Evaluation Form

A detailed medical history and thorough symptom evaluation are critical components of developing a plan to meet your health goals concerning bio-identical hormone replacement therapy. Here at Hawthorne, we believe in treating each patient as a whole, not an individual symptom or lab value. So, we ask that you answer the following questions as accurately and thoroughly as possible so that we can better serve your needs. 

**This form is HIPAA compliant. All information provided will be treated as protected health information and will be kept confidential under Hawthorne Pharmacy's Privacy Practices.

After you complete this evaluation and submit your saliva test kit for processing (if applicable), you may schedule a consultation via our website. You may also contact the compounding lab at 803.227.4452 for help with scheduling or if you have any questions throughout this process. 

Consultations cost $75.00 and are HSA-eligible. Consultations are not billable to insurance.