Hypothyroidism Self-Assessment Thank you for completing the Hypothyroidism Candidacy Quiz. Based on your results, it appears that you are a candidate for the Hypothyroidism Hormone Replacement Therapy program. We understand that you may be experiencing more symptoms than the ones just listed, and we plan to address all of your symptoms and concerns. In order to best serve you, we need to review your medical history. Click HERE to complete and submit your initial hormone therapy consultation form. Once our providers have reviewed your medical history and determined whether you may be eligible, we will contact you to schedule an initial blood draw. Do You Have Hypothyroidism? Is chronic fatigue or low energy a problem for you?YesNo Are you affected by depression or mental confusion?YesNo Have you noticed thinning hair and/or brittle nails?YesNo Have you tried diet and exercise programs without success?YesNo Name* First * Last Email* By providing your email, you will be subscribed to our bi-weekly newsletter with health and beauty tips, delicious recipes, fresh links, and more. You can unsubscribe at any time. What are you interested in?Hormone Replacement Therapy (HRT)Joint & Tendon PRPSexual MedicineMedSpaWeight Loss