Female Hormone Assessment Mental Anxiety Brain Fog Depression Forgetfulness Irritability Lack of Focus Lack of Motivation/Drive Poor Memory Rapid Mood Swings Sleep Disturbances Physical Back/Body/Joint Pain Decreased Exercise Tolerance Dry Eyes Dry Skin Fatigue - Lack of Energy Heart Palpitations Lack of Motivation/Drive Loss of Muscle Tone Migraines/Headaches Night Sweats Osteoporosis/Osteopenia Restless Leg Syndrome (RLS) Thinning Hair Weight Gain (around midsection) Sexual Decreased Sexual Desire Difficulty Achieving Orgasm Hot Flashes Intense PMS Vaginal Dryness Name * First Name Last Name Email * Phone (###) ### #### Questions or Comments for our Medical Team Thank you!
