Women's Initial Step 1 Form

Navigating the Complexities of Hormonal Imbalance

Hormonal imbalances can disrupt your life in subtle and overt ways. Understanding these imbalances is pivotal to regaining control and achieving hormonal harmony.

Specific Signs/Symptoms of Hormonal Imbalance:

  • Mood Swings: Sudden and unexplained changes in mood.
  • Irregular Menstrual Cycles: Variations in cycle length or flow.
  • Low Sex Drive: A decrease in libido.
  • Insomnia: Difficulty falling or staying asleep.
  • Unexplained Weight Gain or Loss: Changes in weight without a clear cause.

Non-Specific Signs/Symptoms of Hormonal Imbalance:

  • Decreased Energy and Endurance: A drop in your usual vitality and physical capabilities.
  • Memory Challenges: Noticing memory lapses or a decline in recall ability.
  • Language Difficulties: Struggling to articulate or find the right words.
  • Poor Concentration: Trouble maintaining focus on tasks.
  • Workplace Challenges: A downturn in performance or satisfaction at work.

The presence of any one of these symptoms doesn't conclusively indicate a hormonal imbalance; however, a combination of several symptoms, especially if they represent a change from your norm, might suggest a need to investigate further.

Your Symptoms Matter

If you've been experiencing a combination of these symptoms, it might be time to explore the possibility of hormonal imbalance. Our Women’s Initial Hormone Assessment Test is your first step towards clarity and wellbeing.

Symptom Checklist Form

Please fill out the form below and we will be in touch soon to let you know if you are a candidate for Hormone Optimization.

Please let us know how you were referred to us:*

What Symptoms Are You Experiencing?

Last Time Lab Work Was Completed? *

Trypanophobia (Fear of Needles)? *

Taking the Next Step

Once you've submitted your symptom checklist, our dedicated team will carefully review your input and reach out to you. We aim to determine if you're a candidate for Hormone Optimization and to discuss potential paths to restore your balance and revitalize your health.

Your journey to wellbeing starts here. Don't let the confusion of symptoms keep you from living your best life. Complete the Women’s Initial Hormone Assessment Test today and take the first step towards a more balanced you.

Peak Performance
34845 Yucaipa Blvd Yucaipa, CA 92399
909-725-9513

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