Thank you for choosing to allow us to help with your hormone imbalances. The purpose of this page is to provide communication between us privately that we can provide better service to your needs. Our pharmacists and other practitioners will need this information to understand your particular needs, because every patient is different and requires specific attention. The more we know about your health, your diet, and your lifestyle will help us recommend the best plan of action for each individual patient.

If you prefer NOT to provide this information in this manner, then we will ask similar questions in private consultation.  Utilizing this form will streamline the process for you, and minimize your consultation time.  If you choose NOT to complete the full form, please fill out the top of the form, then scroll to the bottom and click on "SUBMIT".  

Hormone Replacement Therapy Consultation Form