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Hormone Replacement Therapy - The Aesthetic & Wellness Center

Hormone Replacement Therapy - The Aesthetic & Wellness Center 2025

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The document is a comprehensive Hormone Replacement Therapy Questionnaire that collects personal, medical, and family history from patients seeking hormone therapy. It includes sections on personal data, medical history, symptoms experienced with aging, hormone therapy history, and informed consent for treatment. The document outlines the responsibilities of both the patient and physician regarding payment for services, potential risks associated with hormone therapy, and the lack of insurance coverage for these treatments. It emphasizes the importance of patient compliance and understanding of the treatment process.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your personal data, including your name, date of birth, gender, and age. Ensure all fields are filled accurately for a comprehensive assessment.
Proceed to the Personal Medical History section. Carefully check any relevant medical conditions you have experienced and indicate if you smoke or consume alcohol.
For women, provide details regarding your menstrual history and any contraceptive methods currently in use. This information is crucial for tailored hormone therapy.
In the Family Medical History section, list any significant health issues that run in your family. This helps in understanding potential hereditary risks.
Complete the Hormone Therapy History section by indicating whether you have previously undergone hormone replacement therapy and specify the types of hormones used.
Finally, review all sections for accuracy before signing at the bottom of the form. Your signature confirms that all information provided is true and complete.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Should I see a gynecologist or endocrinologist for menopause?

Endocrinologist. An endocrinologist is a healthcare provider whos an expert in endocrinology the study of your bodys hormones. Endocrinologists diagnose, treat and manage several conditions that affect your endocrine system.

Who can give hormone replacement therapy?

Who can prescribe hormone therapy? Duke Healths certified menopause specialists are obstetrician-gynecologists who can prescribe MHT, but your primary care provider or your ob-gyn can also prescribe hormone therapy.

What type of doctor is best for hormone replacement therapy?

Hormone therapy can be provided by primary care doctors who focus on gender health or by endocrinologists who specialize in hormone management.

What kind of doctor do you need for HRT?

There are Gynecologists, Urologists, Internists, and even Family Practice doctors that prescribe HRT. However, that is not the most important thing that a patient should consider when choosing a doctor for HRT. The most important thing is that the doctor specializes in HRT and has built their practice around it.

What doctor should I go to to check hormone levels?

An endocrinologist is a doctor who specializes in the diagnosis and treatment of hormone-related diseases and conditions. Endocrinologists treat individuals with endocrine conditions and disorders such as: Diabetes mellitus. Thyroid dysfunction.