Do you often feel tired or experience low energy throughout the day? *

Yes

No

Have you noticed a significant drop in motivation or drive? *

Yes

No

Have you experienced a decrease in your sex drive compared to the past? *

Yes

No

Have you noticed a decrease in muscle mass or strength, even with regular exercise? *

Yes

No

Do your muscles feel weaker or recover more slowly after workouts? *

Yes

No

Have you gained weight, particularly around your midsection, despite maintaining your usual diet and exercise routine? *

Yes

No

Do you find it harder to lose fat than before? *

Yes

No

Do you feel more irritable, depressed, or anxious without a clear reason? *

Yes

No

Have you noticed difficulty concentrating or remembering things? *

Yes

No

Do you have trouble falling asleep or staying asleep? *

Yes

No

Do you wake up feeling unrefreshed, even after a full night’s rest? *

Yes

No

Have you noticed a decrease in facial or body hair growth? *

Yes

No

First Name

Last Name *

Email *

Phone *

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