College Pharmacy - Men's Hormone Self Assessment
 
Men's Questionnaire
If you’re concerned about symptoms that may be related to hormonal imbalances, the Hormone Self Assessment Questionnaire is a useful tool. The brief questionnaire asks for general information about your personal and family medical history, your current medications, and the degree to which you are experiencing complaints ranging from fatigue and depression to impotence, weight gain, and loss of muscle tone.

After you’ve filled out the questionnaire, call or visit College Pharmacy for a consultation with a pharmacist who specializes in Hormone Replacement Therapy (HRT) for men and women. Together, you can review your self-assessment questionnaire and discuss your options. The pharmacist may suggest appropriate saliva or blood tests to check your current hormone levels. You will then receive a personalized recommendation for HRT, which can be given to you or faxed directly to your health care practitioner.

Please click on one of the links below.
 
Links to the Men's Hormone Self Assessment

Download the Questionnaire in PDF Format (154 kb)
Download the Questionnaire in MS-Word Format (55 kb)
 
   
 

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