Male Health Questionnaire - Slater Aesthetics & Anti-Aging

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Lasers
BHRT
- Women’s Bioidentical Hormone Replacement Therapy
  - Female Health Questionnaire
  - Female Hormone Balance Quiz
- Men’s Biodentical Hormone Replacement Therapy
  - Male Health Questionnaire
  - Male Hormone Balance Quiz
Hair Loss
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- Customer Experience Survey
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Welcome
Gallery
Services
Specials
- Join our Email List
Lasers
BHRT
- Women’s Bioidentical Hormone Replacement Therapy
  - Female Health Questionnaire
  - Female Hormone Balance Quiz
- Men’s Biodentical Hormone Replacement Therapy
  - Male Health Questionnaire
  - Male Hormone Balance Quiz
Hair Loss
Reviews
Shop
- Gift Cards
Book
Contact
- Customer Experience Survey
Blog

Name*
First Last
Email*
Phone
Have you experienced any of the following symptoms recently? Please select the number that best describes your experiences with one being extremely mild and ten being extremely severe.
Decrease in libido (sex drive)?
Erections less strong?
Lack of energy?
Decrease in strength and/or endurance?
Decrease in "enjoyment in life"?
Sad and/or grumpy?
Noted a recent deterioration in your ability to play sports?
Falling asleep after dinner?
Recent deterioration in your work performance?
Other
CAN WE CONTACT YOU?*
- Yes
- No
Current Patient
- Yes
- No
Name
This field is for validation purposes and should be left unchanged.

Slater Aesthetics Clinic - Atlanta/Buckhead
Chastain Oaks
4840 Roswell Road, Bldg D, Suite 100, Sandy Springs, GA 30342

Slater Aesthetics Clinic - Warner Robins
400 Corporate Pointe, Warner Robins, GA 31088
Email: drslaterclinic@gmail.com

*Disclaimer: This site and its content have been published for informational and advertising purposes only. Results are not guaranteed and vary from patient to patient.

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CONTACT US: (770) 691-0570