IS BHRT Right for Me?

Ready to Reclaim Your Energy, Balance & Hormone Health?
Is Personalized Hormone Care Right for Me?

Take This 5-Minute Assessment to See If Hormone Optimization Is Your Next Step

This short self-assessment helps us determine whether you're a strong candidate for personalized hormone care through our partnership with Amanda Spaak, NP—a Nurse Practitioner with 19 years of experience who specializes in Functional Medicine and root-cause hormone optimization.

If you check multiple symptoms or score high in key hormone categories, you may be an ideal fit to begin our proven 6-step process—a comprehensive approach designed to help you feel like your best self again.

🌿 Not Feeling Like Yourself?

This quick assessment can help you identify whether a hormone imbalance may be the root cause of your symptoms. Simply check off what you're experiencing—your total score will help guide whether lifestyle support or expert hormone care is the best next step.

Let's get started!
Full Name*

First NameLast Name
Age*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Have You Used BHRT or Hormone Therapy Before?*

Yes, I have used hormone therapy in the past but stopped.Yes, I am currently on BHRT but want a second opinion.No, I have never used hormone therapy before.
Symptom Checklist (Check All That Apply to You) - LOW Progesterone*

PMSEarly MiscarriageUnexplained Weight GainAnxietyInsomniaPainful and/or Lumpy BreastsCyclical HeadachesMore IrritableHeavy BleedingInfertilityNight SweatsHeadaches with PeriodsMood SwingsIrregular Periods
Low Progesterone Symptom Score
Symptom Checklist (Check All That Apply to You) - HIGH Testosterone*

AcneExcessive Hair on the Face and ArmsThinning Hair on the HeadOvarian CystsHypoglycemia and/or Unstable Blood SugarInfertilityMid-Cycle PainOily SkinOily HairBody OdorAnger IssuesSalt / Sugar CravingsEasily PerspireIrregular Periods
High Testosterone Symptom Score
Symptom Checklist (Check All That Apply to You) - HIGH Estrogen*

Puffiness and Fluid RetentionRapid Weight GainMood SwingsAnxious DepressionInsomniaRed flush on faceWeepinessBreast TendernessHeavy BleedingMigraine HeadachesFoggy ThinkingBloatng
High Estrogen Symptom Score
Symptom Checklist (Check All That Apply to You) - LOW Estrogen

Vaginal DrynessBladder InfectionPainful IntercourseHot FlashesNight sweatsMemory ProblemsLethargic DepressionFrequent UrinationWeight gainMore TiredDry Scratchy SkinDry EyesInfrequent Light PeriodsIncreased Facial Hair
Low Estrogen Symptom Score
Symptom Checklist (Check All That Apply to You) - LOW ANDROGEN (Testosterone/ DHEA)

Lack of Interest in SexLack of MotivationLess ConfidentLess Competitive DriveLoss of Muscle ToneVaginal DrynessPainful IntercourseUrinary LeakageDecisions are ToughSaggy SkinTiredDepression
Low Androgen Symptom Score
Symptom Checklist (Check All That Apply to You) - LOW Thyroid

Hoarse VoiceLow Blood PressureDifficulty Forming ThoughtsOften tiredInsomniaJoint PainPasty and Pale SkinSlow Pulse RatePeriods of DepressionHigh CholesterolCold Hands and FeetMuscle AchesSleep ApneaDifficultly Losing WeightScalp Hair LossDry SkinItchy Skin in The WinterRecurrent HeadachesTongue EnlargedTemperature Below 98.6ºFReduced Body HairPuffy FaceEyelids SwollenConstipationCold SensitiveNon Restful SleepInfertility or MiscarriagesTired in the AfternoonTingling in your Hands and FeetEyebrows and Eyelashes ThinningSweat Less Than you used toFluid RetentionMore Susceptible to Infection
Low Thyroid Symptom Score
Symptom Checklist (Check All That Apply to You) - Cortisol Imbalance (Adrenal Fatigue)

Trouble waking up in the morningEnergy Crash in the AfternoonHair LossLow Blood PressureFeel Like Passing Out When Standing Up Too QuicklyRecurrent InfectionsEmotional StressLoss of Sex DriveSensitive to LightSensitive to NoisePanic AttacksCraving SaltCraving SugarNeed Caffeine to Make it Through the DayNo Longer Enjoy Things you Used to EnjoyMore Difficulty Coping With StressFeel Tired After Exercising
Stress / Cortisol Symptom Score
Total Score

Add up your score from each category. Score less than 5: Likely not a hormone imbalance issue. Score [5-10]: Hormone imbalance may be at play. Lifestyle changes recommended. A BHRT consultation could be helpful.Score Greater Than [10]: Hormone imbalance likely—lifestyle changes and BHRT consult recommended.
What Are Your Biggest Concerns? (Check all that apply)

Menopausal symptoms (hot flashes, night sweats, vaginal dryness)Fatigue, brain fog, or low energyWeight gain or difficulty losing weightLow libido or sexual health concernsMood swings, anxiety, or depressionMuscle/joint pain or body composition concernsSleep disturbances or insomnia
Are You Ready to Take Action?*

Yes! I’m ready to move forward and work with Amanda.I’m interested but have questions before committing.I’m not sure if BHRT is right for me yet.
Final Question: How Can We Help You?
🔎 What Happens Next?
If your score indicates a strong hormone imbalance:
- ✅ You may be an excellent candidate for BHRT
- 🧠 Our clinical team will review your responses and determine if you’re a match
- 📩 You’ll receive next steps via email—including how to schedule your initial consultation with Kelley
👩‍💻 Stay in the Loop
To avoid missing important next steps, please add consulting@gooddaypharmacy.com to your safe sender list.

📌 Ready to Take Control of Your Health?
If you’re ready to move forward today, we’ll walk you through our 6-step BHRT process—starting with your first consult.

Kelley will guide you the entire way—no guesswork, no overwhelm, just clarity and results.
Should be Empty:

Ready to Reclaim Your Energy, Balance & Hormone Health?

Total Score