Male Bio-Identical Hormone Patient Forms
If you are visiting Allura for Bio-Identical Hormone Replacement Therapy please print and fill out the pertinent forms found below. 15-20 minutes may be required to complete all the forms. Please bring the paperwork to your appointment.
COMPLETE ALL THE ATTACHED NEW PATIENT FORMS AND BRING THEM WITH YOU TO YOUR APPOINTMENT or YOU MAY FAX, MAIL, or EMAIL THE PATIENT FORMS:
- Health History
- General Consent Form
- Fees for pellet therapy
- FAQ sheet
- HIPPA sheet
- Medical Release form
- Insurance Disclaimer
- Lab Disclaimer
Also, please review the Allura Policies prior to visiting the clinic.