Do You Have Memory Loss? 

Do you have difficulty sleeping or do you wake up in the middle of the night? 

Do you suffer from anxiety or depression or are you on medications for them? 

Do you suffer from low energy? 

Are you gaining weight even though you have not changed eating/exercise habits? 

Has sexual desire or performance decreased? 

Is your skin aged significantly or do you have increased wrinkles lately? 

Do you have increased mood swings? 

Are you losing bone or muscle mass? 

Are you taking hormones that are not customized to your needs or are synthetic? 

Let us know what your particular symptoms are:

Would you like to be contacted for a free consultation to discuss your individual 
symptoms and potential solutions? 

If Yes, what is the best number to reach you?

If Yes, when is the best time of day to call you?

If Yes, what dates are best for a consultation?
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Menopause Survey
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