Can The Hormone Center Help You?

Self-Assessment

Find out if The Hormone Center can help you alleviate and treat symptoms and conditions you experience.

Please be sure to click "OK" at the end in order to save your answers.

Question Title

* 1. Patient Information

Name

Email Address

Question Title

* 2. We're asking simple yes or no questions to help us determine if The Hormone Center is a good option for you:

	Yes	No
Do you feel like you're just treating the symptoms of your illness - not the root cause(s)?	Do you feel like you're just treating the symptoms of your illness - not the root cause(s)? Yes	Do you feel like you're just treating the symptoms of your illness - not the root cause(s)? No
Do you feel overly-medicated (like you're taking multiple medications, then taking more to treat the side-effects)?	Do you feel overly-medicated (like you're taking multiple medications, then taking more to treat the side-effects)? Yes	Do you feel overly-medicated (like you're taking multiple medications, then taking more to treat the side-effects)? No
Do you experience have trouble falling/staying asleep?	Do you experience have trouble falling/staying asleep? Yes	Do you experience have trouble falling/staying asleep? No
Do you feel tired all of the time?	Do you feel tired all of the time? Yes	Do you feel tired all of the time? No
Do you experience symptoms associated with thyroid issues, but your test results have come back "normal?"	Do you experience symptoms associated with thyroid issues, but your test results have come back "normal?" Yes	Do you experience symptoms associated with thyroid issues, but your test results have come back "normal?" No
Have you experienced unexplained weight gain?	Have you experienced unexplained weight gain? Yes	Have you experienced unexplained weight gain? No
Are you interested in taking a more proactive approach to your health, rather than a reactive one?	Are you interested in taking a more proactive approach to your health, rather than a reactive one? Yes	Are you interested in taking a more proactive approach to your health, rather than a reactive one? No
Are the medications you're taking not helping?	Are the medications you're taking not helping? Yes	Are the medications you're taking not helping? No
Have you/are you going through menopause/andropause?	Have you/are you going through menopause/andropause? Yes	Have you/are you going through menopause/andropause? No
Does your stress feel like it's unmanageable?	Does your stress feel like it's unmanageable? Yes	Does your stress feel like it's unmanageable? No
Do you experience seasonal allergies?	Do you experience seasonal allergies? Yes	Do you experience seasonal allergies? No
Have you been diagnosed with PCOS?	Have you been diagnosed with PCOS? Yes	Have you been diagnosed with PCOS? No
Are your worried about being on antidepressants or anxiety medications?	Are your worried about being on antidepressants or anxiety medications? Yes	Are your worried about being on antidepressants or anxiety medications? No
Have you experienced "strange" symptoms, such as your eyebrows thinning or ridges on your nails?	Have you experienced "strange" symptoms, such as your eyebrows thinning or ridges on your nails? Yes	Have you experienced "strange" symptoms, such as your eyebrows thinning or ridges on your nails? No
Have you noticed a decline in you or your spouse's sex drive?	Have you noticed a decline in you or your spouse's sex drive? Yes	Have you noticed a decline in you or your spouse's sex drive? No