Questionnaire TRT - Leo for Men

First Name

Last Name

Email

Do any of the following apply to you?

Do you have decreased libido/sex drive?

Do you have a lack of energy?

Do you have decreased strength or endurance?

Have you lost height?

Do you have decreased enjoyment of life?

Are you sad or grumpy?

Are your erections less strong?

Has there been a deterioration in your ability to play sports?

Are you falling asleep at dinner?

Has there been a recent deterioration in your work performance?

Points Total

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TRT Questionnaire