Information forms and List of questionnaires.
Please print and bring any applicable forms/questionnaires to your visit.
Filling out pertinent items ahead of time helps us use our face-to-face time more efficiently.
Some of them belong to other organizations/practices, but I find them useful for our purposes.
If you have any prior records, it is a good idea to bring them to your visit.
List of thyroid symptoms
Fibromyalgia Questionnaire Lyme questionnaire
Three Day Food Diary
The Age Print Quiz
Endocrine system questionnaire
Adrenal Fatigue Questionnaire
Allergy Questionnaire
Memory Questionnaire
Constipation Questionnaire Bowel Assessment Patient Questionnaire
Insomnia Screening Questionnaire
For Women
Menopause Questionnaire (NAMS) Menopause Rating Scale
Incontinence Questionnaire Incontinence Impact Questionnaire
Female Sexual Function Index Sexual Satisfaction Survey
Fertility Questionnaire
Hot Flash Assessment scale
O SHOT Consent form
PCOS Questionnaire
PELLET CONSENT FEMALE
Metagenics Women’s Health Questionnaire
For Men Only
ADAM Questionnaire plus additional questions Andropause Quiz
Male Symptom Questionnaire
Priapus Shot Consent form (“P” Shot)
Andropause article
Male Hormone Questionnaire and Consent
Diet Information Links
The Virgin Diet Quick Start Guide The Virgin Diet Cookbook
Virgin diet sugar impact scale Virgin Diet, Where Dairy and Gluten hide
Paleo Diet Plan Crossfit Quickstart
Candida Cleanse Guide
GAPS diet overview A guide to being underwhelmed on the GAPS diet
SCD Diet for SIBO
Pounds and Inches Original HCG diet protocol
Miscellaneous Information Links
Fertility strategies
Low Dose Naltrexone Low Dose Naltrexone info Low Dose Naltrexone Consent form
Testosterone and the heart
Female Sexual Dysfunction
Addyi Pre-Authorization form Addyi discount card Addyi Consent Form