Testosterone Replacement

1
Enter your name as seen on your ID* This field is required.Proof of identification will be required prior to seeing a physician so we can match you with a provider in your state
First Name
Last Name
2
Enter State of Residence* This field is required.
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
3
Oh no! It appears we do not currently have the ability to see patients in your state. But don't worry, we are working diligently to expand our reach so be sure to check back in often as we may have your state very shortly! Provide your email below and we can let you know when we are available in your state.
example@example.com
4
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
Date of Birth* This field is required.
Date
Year
Month
Day
6
Gender* This field is required.Please provide your assigned gender at birth
Please Select
Please Select
Male
Female
7
How would you rate your current strength/endurance?* This field is required.
Terrible
Poor
Average
Good
Excellent
8
How is your overall enjoyment of life?* This field is required.
Terrible
Poor
Average
Good
Excellent
9
How are your daily energy levels?* This field is required.
Terrible
Poor
Average
Good
Excellent
10
How has your sex drive been lately?* This field is required.
Terrible
Poor
Average
Good
Excellent
11
Are you still obtaining strong erections?* This field is required.
Extremely weak
Weak
Average
Strong
Extremely Strong
12
How would you rate your work performance over the past 4 weeks?* This field is required.
Terrible
Poor
Average
Good
Excellent
13
How often do you lose productivity after dinner?* This field is required.
Every night
5-6x per week
3-4x per week
1-2x per week
Never
14
How would you rate your capability to play sports activities over the past 4 weeks?* This field is required.
Terrible
Poor
Average
Good
Excellent
15
How much height have you lost since you were at your tallest?* This field is required.
2 inches or more
1.5-1.9 inches
1-1.4 inches
0.5-0.9 inches
0-0.4 inches
16
How is your daily happiness level?* This field is required.
Terrible
Poor
Average
Good
Excellent
17
Do you have any of the following medical conditions?* This field is required.
Testicular Injury/Removal
Chemotherapy/Radiation
Anabolic Steroid Use
Obesity
Kidney Disease
Liver Disease
Diabetes
High Blood Pressure
Hyperlipidemia
Heart attack in the last 6 months
History of Stroke
Blood clots
Thyroid Disease
Other
None of the above
18
Please list any additional disorders you have been diagnosed with:
19
Have you been diagnosed with any other following:* This field is required.
Depression
Anxiety
PTSD
Bipolar Disorder
Schizoaffective Disorder
ADHD
Autism
Schizophrenia
Body Dysmorphia Disorder
Substance Use disorder
None of the Above
20
Do you have any known allergies to foods or medications?* This field is required.
YESNO
21
Please list all allergies
22
What Medications do you Currently Take?* This field is required.Include all prescription medications or herbal supplements. If you take no medications then type "none"
Huge
Large
Normal
Small
Ok
Ok
23
Email* This field is required.Please enter your email to create your account
example@example.com
24
Phone Number* This field is required. We do not share this number with any third parties.
Please enter a valid phone number.
25
Please take a Photo of your Drivers License* This field is required.
26
Please take a clear photo of your Face* This field is required.
27
Terms of Services* This field is required.
28
Privacy Policy* This field is required.
29
Testosterone Replacement Subscriptions* This field is required.
prevnext( X )
"Worry Free" Bi-Monthly Testosterone Package
This package includes everything you will need! Labs Included! Minimum 4-month commitment. Shipping is included in the cost.
$350.00 for each two months
SUBSCRIBE
"Worry Free" Semi-Annual Testosterone Package
This package includes everything you will need! Labs Included! Shipping is included in the cost. 12th month free!
$962.50 for each six months
SUBSCRIBE
Testosterone Package Without Labs
Must provide CBC, Total Testosterone, BMP, and PSA (if older than 40). Minimum 3-month commitment. Shipping is included in the cost
$200.00 for the first month then, $110.00 for each month
SUBSCRIBE
Credit Card
First Name
Last Name
Credit Card Number
Security Code
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
2024
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
Expiration Year
Billing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Should be Empty: