Request an Evaluation for TRT, BHRT, or GLP-1 | THE ARMORY | Columbus, Ohio
  • THE ARMORY

  • Request an Evaluation for TRT, BHRT, or GLP-1

  • Today's Date
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  • What would you like to schedule today?*
  • Format: (000) 000-0000.

  • By providing your phone number and submitting this form, you consent to receive SMS text messages from THE ARMORY. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out or HELP for more information. Consent is not a condition of purchase. See our Privacy Policy for details. 

  • Preferred Method of Contact*
  • Date of Birth*
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  • Gender*

  • Insurance Information

    Although THE ARMORY does not bill insurance for any services, we require your insurance information for our records. This information may be used when coordinating prescriptions, obtaining prior authorizations, or referring you to outside providers such as labs, imaging centers, or specialists.
  • Do you have health insurance?*
  • Please select your insurance provider. We do not bill insurance directly, but keep this on file to help coordinate your care.
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  • Pharmacy and Laboratory Information

    Please provide your preferred pharmacy and laboratory information. This allows our team to coordinate prescriptions, prior authorizations, and lab testing efficiently. If you haven’t had recent labs drawn, we’ll generate an order for you and contact you once results are available to schedule your provider visit.
  • Do have a preferred pharmacy?*
  • What is the name of your preferred pharmacy?
  • Do have a preferred lab for blood draws?*
  • What is the name of your preferred lab?

  • Hormone Replacement Therapy

  • Are you currently on hormone replacement therapy?*
  • Do you have any biological children?*
  • Do you have any fertility concerns?*
  • Do you wish for children in the future?*
  • Please select any symptoms you’re currently experiencing. Check all that apply.
  • Please select any symptoms you’re currently experiencing. Check all that apply.
  • I currently feel as if I am....*
  • Are you current on your women’s health screenings, such as Pap smear and mammogram?*
  • Do you have a PERSONAL history of breast, uterine or ovarian cancer? Or history of other hormone receptor positive cancer?*
  • Do you have a known FAMILY history of breast, uterine or ovarian cancer?*

  • Hormone Replacement Therapy Laboratory Testing

    Before starting hormone replacement therapy, certain lab tests are required to ensure treatment is appropriate and safe. These include hormone levels and other key health markers that must be reviewed by your provider.

    If you’ve already had recent lab work completed elsewhere, please let us know and upload those results below so we can review them. If not, we’ll arrange to have your labs drawn before your first provider visit to make the process more efficient.

  • Have you recently had any lab work completed that you would like to share with us?*
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  • Acknowledgment

    If you have not uploaded recent or acceptable lab results, THE ARMORY will generate a lab order on your behalf. This order will be sent to you with instructions for completing your bloodwork at a nearby lab. Once your results are received, a provider from our practice will review them and contact you to schedule your appointment.

    After completing your labs, you’ll be expected to establish care with our practice to review and discuss your results. Please note that completing labs does not guarantee a prescription for hormone replacement therapy. The decision to prescribe will be based solely on your provider’s clinical judgment and whether treatment is deemed medically appropriate.

    While THE ARMORY does not accept insurance for services provided at our facilities (such as office visits or performance medicine testing), we require your insurance information for labs, external referrals, and prescriptions to help reduce out-of-pocket costs.

    Office visit fees typically range from $150 to $275. A Medical Membership option is also available for $195 per month, which includes unlimited medical visits, performance medicine testing, and access to all three fitness facilities.

     

  • GLP-1 Therapy

  • Have you ever used a GLP-1 medication before?*
  • Which GLP-1 medication did you try? (Check all that apply)*
  • Did you have any side effects or complications?*
  • Do you have a history of any of the following? (Check all that apply)*
  • What are your primary goals with GLP-1 therapy? (Check all that apply)*
  • How long have you been working toward these goals (through diet, exercise, etc.)?*
  • Have you had a DEXA scan or Resting Metabolic Rate (RMR) test at THE ARMORY before?*
  • Have you ever worked with a registered dietitian or nutrition coach?*
  • Have you ever worked with a personal trainer or fitness coach*
  • What is your average weekly physical activity level?*
  • Are you willing to complete baseline labs and follow-up testing (DEXA, RMR, etc.) as part of this program?*
  • Are you open to working with our dietitian or performance coach to support long-term results?*
  • Are you willing to commit to a regular exercise program?*
  • Do you understand that GLP-1 therapy is a medical tool meant to complement — not replace — lifestyle change?*
  • How did you hear about THE ARMORY?*
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