Welcome to the Future of Health

We're excited to help you start your journey toward a healthier, more vibrant life.

Eligibility Questionnaire

Answer a few quick questions to see if you may be eligible for physician-guided testosterone therapy.

First Name

Last Name

Email Address *

Phone Number *

Date of birth *

What state do you currently live in? *

Symptoms

Which symptoms are you currently experiencing? (Select all that apply.) *

How long have you been experiencing these symptoms? *

Less than 6 months

6–12 months

Over 1 year

How would you describe your energy levels on most days? *

Consistently low

Up and down

Mostly normal

High

Have you ever had your testosterone levels checked? *

Yes — and they were low

Yes — but I was told they were “normal”

No — never checked

Have you ever used testosterone therapy or medications to raise testosterone? *

No

Yes — testosterone injections

Yes — clomiphene / enclomiphene

Are you currently trying to conceive or planning to in the next 6–12 months? *

Yes

No

Unsure

Are you open to physician-guided testosterone therapy if labs and medical review indicate it’s appropriate? *

Yes

No

Acknowledgment *

I understand that completing this questionnaire does not guarantee treatment, and that all care decisions are made by a licensed physician based on labs and medical history.

You May Be Eligible

Based on your answers, you may qualify for physician-guided testosterone therapy.

Click the button below to complete your submission and continue to at-home lab testing and physician review.

Labs and review are required before any treatment decisions are made.

Welcome to the Future of Health

We're excited to help you start your journey toward a healthier, more vibrant life.

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