Men's Questionnaire

Are you sad and or grumpy?

Yes

No

Have you noticed a decreased
enjoyment of life?

Yes

No

Has there been a recent deterioration in
your work performance?

Yes

No

Have you lost height?

Yes

No

Do you have a decrease in
strength/endurance?

Yes

No

Have you noticed a recent deterioration
in your ability to play sports?

Yes

No

Do you have a lack of energy?

Yes

No

Are you falling asleep after dinner?

Yes

No

Do you have a decrease in
libido (sex drive)?

Yes

No

Are your erections less strong?

Yes

No

What’s your name, email and phone number?

Once you provide this information, we’ll calculate your results.

* denotes a required field.