Skip to content
Free Consultation
For more Information Call:
877-415-3350
Home
Our Process
Regenerative Medicine
EMTT Therapy
PRP Therapy
Shockwave Therapy
Weight Loss
Hormone Replacement
HRT Male
HRT Female
T Shape 2
IV Therapy
Health Assessment
Male
Female
Patient Resources
Patient Intake Forms
Frequently Used Medications
Information & Articles
Blog
About Us
Home
Our Process
Regenerative Medicine
EMTT Therapy
PRP Therapy
Shockwave Therapy
Weight Loss
Hormone Replacement
HRT Male
HRT Female
T Shape 2
IV Therapy
Health Assessment
Male
Female
Patient Resources
Patient Intake Forms
Frequently Used Medications
Information & Articles
Blog
About Us
For more Information Call:
877-415-3350
Home
Our Process
Regenerative Medicine
EMTT Therapy
PRP Therapy
Shockwave Therapy
Weight Loss
Hormone Replacement
HRT Male
HRT Female
T Shape 2
IV Therapy
Health Assessment
Male
Female
Patient Resources
Patient Intake Forms
Frequently Used Medications
Information & Articles
Blog
About Us
Home
Our Process
Regenerative Medicine
EMTT Therapy
PRP Therapy
Shockwave Therapy
Weight Loss
Hormone Replacement
HRT Male
HRT Female
T Shape 2
IV Therapy
Health Assessment
Male
Female
Patient Resources
Patient Intake Forms
Frequently Used Medications
Information & Articles
Blog
About Us
Free Consultation
Take Your Health Assessment
Sex Drive:
Has your sex drive decreased compared to the past?
Yes
No
Energy Levels:
Do you have less daily energy than you used to?
Yes
No
Strength & Endurance:
Have you noticed a decrease in your overall strength and/or endurance?
Yes
No
Height:
Have you lost height?
Yes
No
Enjoyment of Life:
Have you noticed a decreased enjoyment of life?
Yes
No
Mood:
Do you often feel sad and/or irritated?
Yes
No
Work Performance:
Is your work performance deteriorating?
Yes
No
Performance Strength:
Is your performance less strong than it used to be?
Yes
No
Maintaining Erection:
Has it become more difficult to maintain an erection throughout intercourse?
Yes
No
Number of Erections:
Have you experienced a decrease in the number of morning erections?
Yes
No
Weight:
Are you experiencing weight gain or decreased muscle mass/increased body fat?
Yes
No
Breast Changes:
Are your breasts enlarged?
Yes
No
Sleepiness after Dinner:
Do you frequently fall asleep after dinner?
Yes
No
Sleep:
Do you have trouble sleeping such as falling asleep/difficulty sleeping through the night.
Yes
No
Overall Health:
Have you experienced any decline in your health?
Yes
No
Take Charge of Your Health with Our Free Health Consultation
If you answered
"Yes"
to
3 or more
of these questions, it would be beneficial for you to discuss your health and symptom reduction solutions with our specialists. We would like to provide you with a free consultation with our concierge medical specialists who can provide you with a customized wellness program to address your specific needs and optimize your overall health.
First Name
Last Name
Email
Phone
Zip
Do you have a Progressive Health and Rejuvenation representative ? If so please tell us who your representative is:
Message
Submit
