Free Low-T Assessment Quiz
Answer a few quick questions to see whether your symptoms may be related to low testosterone.
How old are you?
*
Under 25
25–34
35–44
45–54
55+
Which symptoms are you currently experiencing? (Select all that apply)
*
Persistent fatigue or low energy
Reduced libido
Mood changes or irritability
Brain fog or poor concentration
Loss of muscle mass
Increased body fat (especially around the waist)
Reduced motivation
Poor sleep
None of the above
How long have these symptoms been present?
*
Less than 3 months
3–6 months
6–12 months
Over 12 months
How would you rate your current energy levels?
*
Very low
Low
Average
Good
Excellent
How is your mood and motivation recently?
*
Low / struggling
Up and down
Mostly fine
Are you currently struggling to lose weight or maintain muscle despite diet or exercise?
*
Yes
No
Not applicable
Have you noticed changes in muscle mass or strength?
*
Yes, noticeable loss
Slight loss
No change
Have you gained body fat, especially around the stomach?
*
Yes
Slightly
No
How would you rate your mental clarity/focus?
*
Poor
Average
Good
How is your sleep quality?
*
Poor
Fair
Good
Excellent
How often do you exercise?
*
3+ times per week
1–2 times per week
Rarely
Never
How often do you exercise?
*
3+ times per week
1–2 times per week
Rarely
Never
Stress level in daily life:
*
High
Moderate
Low
Have you ever had your testosterone checked?
*
Yes, and it was low
Yes, but unsure of the result
No
Prefer not to say
Do you have a history of any of the following?(Tick any that apply)
*
High blood pressure
Type 2 Diabetes
Sleep apnoea
Cardiovascular disease
Depression/anxiety
Prostate issues
None of the above
What is your main health goal right now?
*
Improve energy
Improve libido
Lose weight / reduce belly fat
Improve mood and focus
Overall health optimisation
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Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Gender
*
Please Select
Male
Female
N/A
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Acknowledgement and consent
*
I have read, understand and acknowledge above information about the weight loss program.
*
I agree to be contacted about my assessment results.
*
I understand this assessment does not replace medical advice.
Consent
*
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