Electronic HRT Forms
Electronic HRT Consultation Forms
To begin your HRT consultation, please select the location you plan to visit from the options below.
Each form is securely hosted on a third-party platform. Before accessing the form, you will complete a brief security verification to help protect your information. Once verified, you will be automatically redirected to the appropriate form for your selected location.
Please ensure you choose both the correct location and the appropriate Male or Female consultation form before proceeding.
Important: Please open each form and click “Submit” so it is recorded as complete in our system, even if no fields are required.
To ensure your consultation is as productive and personalized as possible, please complete the following steps before scheduling your appointment:
1. Complete your evaluation packet in full. After completing each form, be sure to click “Submit” before moving on to the next form, even if no required fields appear on that page.
2. Complete your lab work or saliva testing.
3. Ensure your lab results are dropped off or faxed to the pharmacy so our pharmacists can thoroughly review them and prepare personalized recommendations for your consultation.
Consultations can only be scheduled once your packet is fully completed and your lab results have been received by the pharmacy.
Once all items are complete, you may schedule your consultation on our website or contact the pharmacy directly to schedule.
Important:
These forms are intended for patients who are actively interested in starting hormone therapy or scheduling a consultation.
If you are simply looking for general information, please contact our pharmacy directly and we would be happy to answer your questions. Completing these forms initiates our intake and review process.
Avon
For patients planning to visit our Avon location
Male HRT Consultation – Avon
For male patients completing an HRT consultation at the Avon location
Female HRT Consultation – Avon
For female patients completing an HRT consultation at the Avon location
Perrysburg
For patients planning to visit our Perrysburg location
Male HRT Consultation – Perrysburg
For male patients completing an HRT consultation at the Perrysburg location
Female HRT Consultation – Perrysburg
For female patients completing an HRT consultation at the Perrysburg location
Sandusky
For patients planning to visit our Sandusky location
Male HRT Consultation – Sandusky
For male patients completing an HRT consultation at the Sandusky location
Female HRT Consultation – Sandusky
For female patients completing an HRT consultation at the Sandusky location
Locations & Contacts
Hours
Monday - Friday:
9:00am - 6:00pm
Sat & Sun: Closed
Hours
Monday - Friday:
9:00am - 6:00pm
Sat & Sun: Closed