REQUIRED DOCUMENTS


Complete and Sign


MEDICAL HISTORY

Fill-out and sign your complete medical history online.


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FOR WOMEN ONLY

Women, please fill out this form and submit it along with your medical history.


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MEDICAL AUTHORIZATION

Fill-out and sign your medical authorization forms online.


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DRIVER’S LICENSE

Fax (561-658-6212) or email (documents@andrologix.com) a photo of your license.


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YEARS EXPERIENCE

Improving the lives of thousands of men and women just like you!



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LOCATIONS

Skilled professionals in key metropolitan areas across the country.



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HAPPY HEALTHY CLIENTS

We have a long history of helping our clients take control of their health.



Optional Forms:

Please DO NOT complete any of the following forms unless you were specifically requested to do so.


PBPM Telehealth Forms:

DO NOT complete any of the following unless you are a new or existing patient of our West Palm Beach, Florida affiliate clinic.

Main Office

701 Northpoint Parkway
West Palm Beach, FL 33409

Call (877) 741-6069

HRT Benefits:

• More Energy
• Less Body Fat
• Enhanced Libido
• Improved Mood & Memory
• Greater Confidence

*Andrologix Health and Wellness can only provide prescriptions or therapy services to patients who have a clinical need. To determine a clinical need, patients must complete any required lab work, physician consultations, examinations and a medical history review. Please note that even if you complete these steps, a clinical necessity for our prescriptions or hormone therapy may not be found. Any claims or opinions stated within our website should not be construed as medical advice or as a diagnostic. These products are not intended to diagnose, treat, cure or prevent any disease. Please be advised that the statements on this informational website have not been evaluated by the Food and Drug Administration.