“To control your hormones is to control your life.”
~Barry Sears, Ph. D.

Women - Female Self-Guided Diagnosis Test

The Self test

We invite you to take the following self-examination and see for yourself if you are a candidate to feel better, feel stronger, look better, and reach performance levels like you were a kid again!

Do you have less energy?

Yes
No

Do you have trouble sleeping or sleep less restfully?

Yes
No

Do you have hot flashes?

Yes
No

Have you had a hysterectomy and not felt the same since?

Yes
No

Have you experienced changes in your hair (thinning hair or increased facial or body hair)?

Yes
No

Have you had weight gain?

Yes
No

Do you have memory lapses?

Yes
No

Do you have thinning skin?

Yes
No

Do you now have less muscle?

Yes
No

Do you have irregular cycles?

Yes
No

Do you have a low libido?

Yes
No

Do you have vaginal dryness?

Yes
No

Do you have foggy thinking?

Yes
No

Do you feel stressed out, feel anxious, or do you worry a lot?

Yes
No

Are you depressed and/or do you feel less happy than you once did?

Yes
No

Do you find it hard to fall asleep and/or if you fall asleep do you frequently wake up in the night?

Yes
No

Do you have any other misc symptoms that you have seen your primary care Doctor about and they said "it's just part of getting older"?

Yes
No

Do you have mood swings?

Yes
No

Click to receive results and feedback on your survey. A specially trained staff member will provide you with line-by-line feedback and an overall synopsis of your situation. In addition, the Specialist will discuss possible causes for each item and treatment options.

We do not have an automated system generating canned feedback. A Specialist reviews each prospective patients information and provides no cost medical consultations. Whether you visit us or not, we want to see you and others in the community happy and well. Our team do whatever they can to help you accomplish your objectives.
*Name
  
Telephone
*Email Address
  
Date of birth (MM/DD/YY)
 

Address

7810 Ballantyne Commons Parkway
Suite 200
Charlotte, NC 28277
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Map to Revita Anti-aging offices