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Membership Program
Information on retainer for physician to provide wellness and related care for one complete year.
Member Program

Aging Male Symptom Scale
This scale was developed to screen for low testosterone, and developed by Dr Heinemann in Germany

Self Administered Evaluation Form
If you are a new patient, please fill in this form and present at appointment.

Patient Privacy Notice
If you are a new patient, please read the Patient Privacy Notice and complete form.

Food Diary
If you wish to consult for weight loss and preventive health, please fill in this form.

Consent to pay for non-covered services
This payment agreement form is to be completed and presented at appointment.

ADAM Questionnaire
If you are male, and would like to be screened for low testosterone (andropause or hypogonadism), please complete form.