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Your email address?
Your phone number?
When is the best time to call you to help you schedule your appointment?
I have no preference for whether I see a male or female physician
I prefer to see a male physician
I prefer to see a female physician
How did you learn about our clinic?
Which services are you interested in? Check all that apply.
Testosterone & Hormone Replacement Therapy with Intramuscular or Subcutaneous Injections
Testosterone & Hormone Replacement Therapy with Subcutaneous Pellets Implantation
Growth Hormone Replacement Therapy
Comprehensive Hormone Replacement Therapy
POTENTwave™ Ultrasound Therapy for Erectile Dysfunction
Trimix Injection Therapy for Erectile Dysfunction
Other Therapy for Erectile Dysfunction
Regenerative Injection Therapies to Heal Aging or Damaged Tissues
When would you like to have your appointment?
Share some dates and times that would work well for you to come in for your first appointment.
Would you like to share any other information with us?
We're excited to help you!
Thank you for your consideration. We will call you within four business hours to help you schedule your appointment.
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