Step 1 of 12 0% Let's Get Started!! Take our FREE health survey and discover potential issues preventing you from reaching your health goals. Based on your answers, we present possible medical, lifestyle, environmental and body chemistry issues hindering your progress. Also, we recommend assessments designed to dig deeper and develop a plan to reach your goals.Full Name* First Name Last Name Email* Phone*Please Select The Closest City To You*Select a CityLouisville, KY Area (Includes Southern Indiana)Lexington, KY AreaCincinnati, OH Area (Includes Northern Kentucky)OtherYour City* Next, tell us your gender.* Female Male And now, enter your birth date:*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920By clicking next, you are confirming that your birth date is accurate, agree to survey disclosure & grant permission for 25 Again to communicate with you via text messages concerning appointment scheduling and other relevant information. Msg & data rates may apply. Ok, great. Let's get into your medical history.First, tell us about your blood pressure.Have you been told your blood pressure is greater than 120/80?* Yes No Do you take medications to control blood pressure?* Yes No Have you been told you are pre-diabetic or diabetic?* Yes No Do you take medications to control diabetes?* Yes No Have you ever had a panic attack?* Yes No Do you take medications for depression?* Yes No Next, tell us your goals.Please rate the importance of addressing these goals for your health today.Lose Weight/Improve Body Image, Composition* Very Important Important Moderately Important Of Little Importance Not Important Increase Energy, Improve Metabolism* Very Important Important Moderately Important Of Little Importance Not Important Improve Sex Drive, Sexual Performance, Sexual Function Very Important Important Moderately Important Of Little Importance Not Important Sleep Better, Wake up Rested* Very Important Important Moderately Important Of Little Importance Not Important Improve Mental Clarity & Memory* Very Important Important Moderately Important Of Little Importance Not Important Improve Mood, Positive Outlook, Decrease Anxiety* Very Important Important Moderately Important Of Little Importance Not Important Prevent-Delay Future Disease* Very Important Important Moderately Important Of Little Importance Not Important Eliminate Hot Flashes, Night Sweat or Other Age Related Symptoms* Very Important Important Moderately Important Of Little Importance Not Important Feel, Look Younger* Very Important Important Moderately Important Of Little Importance Not Important Tell us what's going on, what symptoms do you face?To the best of your ability, please answer the questions below:Physical IssuesMy feet are too hot at night.* Never Sometimes Regularly Often Constantly My hands and feet are always cold.* Never Sometimes Regularly Often Constantly I have hot flashes and sweats.* Never Sometimes Regularly Often Constantly I'm sensitive to cold.* Never Sometimes Regularly Often Constantly My joints hurt (fingers, wrists, elbows, feet, ankles, knees).* Never Sometimes Regularly Often Constantly My joints are stiff.* Never Sometimes Regularly Often Constantly I am constipated.* Never Sometimes Regularly Often Constantly I crave salty.* Never Sometimes Regularly Often Constantly I have abundant, light-colored urine during the day.* Never Sometimes Regularly Often Constantly I have low blood pressure.* Never Sometimes Regularly Often Constantly Physical AppearanceMy face has become slack and more wrinkled.* Never Sometimes Regularly Often Constantly My cheeks sag.* Never Sometimes Regularly Often Constantly My hair is thinning.* Never Sometimes Regularly Often Constantly My gums are receding.* Never Sometimes Regularly Often Constantly My hair is dry.* Never Sometimes Regularly Often Constantly My skin and eyes are dry.* Never Sometimes Regularly Often Constantly My skin is thin and/or dry.* Never Sometimes Regularly Often Constantly I look older than I am.* Never Sometimes Regularly Often Constantly I have dry skin.* Never Sometimes Regularly Often Constantly In the morning, my face is puffy and my eyelids are swollen.* Never Sometimes Regularly Often Constantly I'm losing hair under my arms or in my pubic area.* Never Sometimes Regularly Often Constantly I am losing hair on top of my head.* Never Sometimes Regularly Often Constantly I'm getting thin, vertical wrinkles above my lips.* Never Sometimes Regularly Often Constantly My eyes are dry and easily irritated.* Never Sometimes Regularly Often Constantly My face is too hairy.* Never Sometimes Regularly Often Constantly Exercise and StaminaI tire easily with physical activity.* Never Sometimes Regularly Often Constantly I am constantly tired.* Never Sometimes Regularly Often Constantly I feel exhausted.* Never Sometimes Regularly Often Constantly It's hard to recover after physical activity.* Never Sometimes Regularly Often Constantly Mental and Emotional StateI feel less self-confident and more hesitant.* Never Sometimes Regularly Often Constantly I don't like the world. I tend to isolate myself.* Never Sometimes Regularly Often Constantly I feel anxious and worried.* Never Sometimes Regularly Often Constantly I tend to worry about things I can't control.* Never Sometimes Regularly Often Constantly I'm feeling drained and I have a hard time handling stress.* Never Sometimes Regularly Often Constantly I feel like my mind is foggy.* Never Sometimes Regularly Often Constantly I feel like I'm living in slow motion.* Never Sometimes Regularly Often Constantly I don't see colors as brightly as before.* Never Sometimes Regularly Often Constantly I have lost interest in art, and don't appreciate it much anymore.* Never Sometimes Regularly Often Constantly I have memory loss.* Never Sometimes Regularly Often Constantly I can't tolerate noise.* Never Sometimes Regularly Often Constantly I am depressed.* Never Sometimes Regularly Often Constantly I cry easily.* Never Sometimes Regularly Often Constantly I'm irritable and aggressive.* Never Sometimes Regularly Often Constantly I lose my self-control.* Never Sometimes Regularly Often Constantly My close friends complain I am nervous and agitated.* Never Sometimes Regularly Often Constantly Menstrual CycleI am still menstruating.* Yes No I do not feel like making love anymore.* Never Sometimes Regularly Often Constantly My menstrual flow is light.* Heavy Moderate Low Very Low None My cycles are irregular, too short, or too long.* Never Sometimes Regularly Often Constantly I have heavy periods.* Never Sometimes Regularly Often Constantly And are continuously painful.* Never Sometimes Regularly Often Constantly My breasts are swollen and tender or painful before my period.* Never Sometimes Regularly Often Constantly Sexual HealthI feel like making love less often than I used to* Never Sometimes Regularly Often Constantly My sexual drive is low.* Never Sometimes Regularly Often Constantly My sexual performance is poorer than it used to be.* Never Sometimes Regularly Often Constantly I don't have much hair in the pubic area.* Plenty Fair Amount Barely A Few Hairs Hairless I don't have much fatty tissue in the pubic area.* Fully Padded Slightly Padded Flat Slightly Fatty Fat My body doesn't have much of a special scent during sexual arousal.* Never Sometimes Regularly Often Constantly Weight and Body ImageMy breasts are getting fatty.* Never Sometimes Regularly Often Constantly My breasts are droopy.* Never Sometimes Regularly Often Constantly My breasts are large.* Never Sometimes Regularly Often Constantly My lower belly is swollen.* Never Sometimes Regularly Often Constantly My belly is getting fat.* Never Sometimes Regularly Often Constantly My abdomen is flabby -- I have a spare tire.* Never Sometimes Regularly Often Constantly I put on weight easily.* Never Sometimes Regularly Often Constantly I've lost muscle tone.* Never Sometimes Regularly Often Constantly My muscles are flabby.* Never Sometimes Regularly Often Constantly Sleep and EnergyI have trouble falling asleep at night.* Never Sometimes Regularly Often Constantly My mind is busy with anxious thoughts while I am trying to fall asleep.* Never Sometimes Regularly Often Constantly I smoke, drink, and/or use a beta blocker as a sleep aid.* Never Sometimes Regularly Often Constantly I sleep light and restlessly.* Never Sometimes Regularly Often Constantly I wake up during the night.* Never Sometimes Regularly Often Constantly And I can't get back to sleep.* Never Sometimes Regularly Often Constantly I have trouble getting up in the morning.* Never Sometimes Regularly Often Constantly When I get up, I don't feel rested.* Never Sometimes Regularly Often Constantly I feel like I'm living out of sync with the world: going to bed late and waking up late.* Never Sometimes Regularly Often Constantly I cannot tolerate jet lag.* Never Sometimes Regularly Often Constantly You have completed this health survey. Please click submit to receive your results.HiddenFemale Estrogen NumberHiddenMale Testosterone NumberHiddenFemale Testosterone NumberHiddenMale HGH NumberHiddenFemale HGH NumberHiddenMale DHEA NumberHiddenFemale DHEA NumberHiddenMale Thyroid NumberHiddenFemale Thyroid NumberHiddenMale Melatonin NumberHiddenFemale Melatonin NumberHiddenMale Pregnenolone NumberHiddenFemale Pregnenolone NumberHiddenFemale Progesterone NumberHiddenevwlWeight Loss Heart Health MetabolismHiddenevshSexual Health/Performance & HormonesHiddenevfeFatigue, Energy, Restorative Sleep & OptimizationHiddenevdpAutoimmune, Inflammation & Disease PreventionHiddenevmhMental Health, Mood, Clarity & Focus, Emotional SupportHiddencdiaDiabetesHiddenchtnHypertensionHiddencdepDepressionHiddencanxAnxietyHiddengowlLose Weight/Improve Body Image, CompositionHiddengoieIncrease Energy, Improve MetabolismHiddengoisImprove Sex Drive, Sexual Performance, Sexual FunctionHiddengosbSleep Better, Wake up RestedHiddengomcImprove Mental Clarity & MemoryHiddengomoImprove Mood, Positive Outlook, Decrease AnxietyHiddengopdPrevent-Delay Future DiseaseHiddengoehEliminate Hot Flashes, Night Sweat or Other Age Related SymptomsHiddengofyFeel, Look YoungerPhoneThis field is for validation purposes and should be left unchanged. 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