This download includes all of the forms below in one file.
Download All Forms
You can help expedite your initial consultation with us by downloading and completing our Patient Registration Form prior to your first visit.
HIPAA Notice of Privacy Practices
We are required by law to keep medical information about you private, to give you this notice of our legal duties and privacy practices with respect to your medical information, and to follow the terms of the notice that is currently in effect.
Privacy Practice Reception
We must have all patients sign the Reception Form to prove that we have made our privacy policies available for your review.
Consent for Testosterone Replacement Therapy
This consent form is your agreement to undergo testosterone replacement therapy, and must be completed prior to therapy being administered.
Health History Questionnaire
This form helps us gain a better understanding about your overall health. The more complete this form, the better our clinicians can tailor your treatment to you.
This form outlines how you intend to pay for your treatment, including your insurance billing information.
Agreement Not to Use Other Testosterone Supplementation
This form is your promise to not combine other testosterone supplementation with your treatment plan.