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Men's Health Assessment

Men Assessment to overall health & wellness

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Question 1 of 10

Do you have reduced energy, motivation, and initiative?

A

Yes

B

No

Question 2 of 10

Do you lack self confidence?

A

Yes

B

No

Question 3 of 10

Do you lack concentration and/or focus?

A

Yes

B

No

Question 4 of 10

Are you noticing recent changes in your short term memory and find yourself forgetting things more frequently?

A

Yes

B

No

Question 5 of 10

Do you find yourself have less restful nights and/or sleep disturbance?

A

Yes

B

No

Question 6 of 10

Have you noticed a decrease in overall muscle mass along with increase in body fat regardless of activity levels?

A

Yes

B

No

Question 7 of 10

Have you noticed that you feel down, depressed or quick to temper more frequently?

A

Yes

B

No

Question 8 of 10

Do you feel that you have a decreased interest in sex or issues with obtaining or maintaining an erection?

A

Yes

B

No

Question 9 of 10

Please provide your full name?

Question 10 of 10

What is your email address and phone number?

Confirm and Submit