Evaluation must be completed at least two days prior to your consult or you may be asked to reschedule your appointment.

From a clinical management point of view, it is very useful to gain a detailed history of possible hormone deficiencies. The answers provided in the questions below will allow the pharmacist to maintain your medical history and will help in advising about current medical therapies. All information provided will be kept confidential.

Please allow a minimum of 30 minutes to complete the questionnaire. You may complete our online form and submit securely through our HIPAA-compliant portal or you may print the PDF file, fill out the form and deliver to the pharmacy at least two days prior to your consult.



Female BHRT Evaluation Form

Click here to download the PDF version.



Female Follow-up Form

Click here to download the PDF version.