What is your primary concern?

How long has this been occurring?

Have you tried any of the following before?

Are you taking nitrates (e.g. nitroglycerin, isosorbide) or recreational “poppers”?

Taking nitrates with PDE5 inhibitors can cause a severe, life-threatening drop in blood pressure.

Can you walk briskly for 10 minutes or climb 2 flights of stairs without chest pain or shortness of breath?

Are you taking alpha-blockers (e.g. tamsulosin) or medications for blood pressure or prostate?

What methods have you previously tried to manage your weight?

Do you or any immediate family member have a history of Medullary Thyroid Carcinoma (MTC) or Multiple Endocrine Neoplasia type 2 (MEN 2)?

GLP-1 and GIP receptor agonists are strictly contraindicated in patients with personal or family history of MTC or MEN 2.

Have you ever been diagnosed with acute or chronic pancreatitis?

Do you have a history of severe gastrointestinal disease (e.g. severe gastroparesis) or active gallbladder disease?

Which administration format do you prefer?

Where are you noticing thinning or looking to improve density?

How long has this concern been present?

Have you tried any hair loss or beard growth treatments in the past?

How would you describe your scalp and facial skin health?

Do you have a history of liver disease or prostate conditions (e.g. elevated PSA)?

What treatment approach do you prefer?

What are your primary health & performance priorities?

How would you describe your current daily energy?

When was your last comprehensive blood test?

Average nightly sleep duration

Phlebotomy Blood Draw Preference

How would you describe your facial skin type?

What are your primary skin goals? (Select all that apply)

Do you currently wear daily facial sunscreen (SPF)?

Have you ever used active prescription retinoids (Tretinoin, Retin-A)?

Routine Preference