booking-assessment

1

What is your age group?* This field is required.

Under 30

Under 40

Under 50

50+

2

Have you noticed any of the following?* This field is required.(Select all that apply then click 'Next')

Constant fatigue or low energy

Reduced mental sharpness or memory

Lower libido or sexual performance

Low mood or irritability

Poor sleep and frequent waking

Difficulty building or maintaining muscle

None of the above

3

How long have these changes been affecting you?* This field is required.

Just started

1–3 months

3–6 months

6–12 months

Over a year

4

After a full night's sleep, how do you feel?* This field is required.

Refreshed and focused

Still tired or foggy

Inconsistent – some days are better than others

5

Which best describes your current lifestyle?* This field is required.

Business Owner or Executive

Desk-based professional (e.g. office, finance, IT)

Physically active job (e.g. tradie, hospitality, retail)

Retired or Semi-retired

Other

6

How would you describe your typical daily workload?* This field is required.

Mentally demanding – meetings, decisions, high responsibility

Physically demanding – long hours on your feet or moving

Balanced

Low stress

7

Do you have history with any of the following?* This field is required.(Select all that apply then click 'Next')

Heart disease

Liver or kidney disease

Cancer

Glaucoma

Blood clots / other blood conditions

None of the above

8

Have you tried any of the following?* This field is required.(Select all that apply then click 'Next')

Supplements / test boosters

Nootropics or peptides

TRT or HRT in the past

Diet/exercise/lifestyle changes

Haven’t tried anything yet

9

Have you ever had your testosterone or hormone levels tested before?* This field is required.

Yes, recently

Yes but awhile ago

No, never

10

How important is it for you to get answers & take action?* This field is required.

Very important – I’m ready now

Somewhat important – still considering

Just curious at this stage

11

If you could restore your energy, mental sharpness, and drive, how much of a difference would that make on your work and life?* This field is required.

Big difference

Some difference

Not much / unsure

12

Almost Done! Name?* This field is required.

First Name

Last Name

13

Email* This field is required.

example@example.com

14

Phone Number* This field is required.

example: 0431 xxx xxx