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JUVEDERM / BOTOX
JUVEDERM / BOTOX
Low Testosterone Questionnaire
Read through the following list and check how many items apply to you:
I often fall asleep after dinner.
My erections are not as strong as they used to be.
I have a lack of energy.
I have noticed a decrease in my life enjoyment.
I have lost height.
I often have difficulty keeping my mind on task.
I often feel sad, irritable or moody.
I have a decreased sex drive.
I have noticed a lack of interest in working out and see little results.
I have noticed a decrease in my strength and/or endurance.
I have noticed diminishing interest in my work and work performance.
Title: *
Mr.
Dr.
First Name: *
Last Name: *
Phone: *
Email Address: *