We're glad you've decided to take the next step towards improved health and wellness. Prior to completing our Male Questionnaire, we recommend to have your recent medical records including dates for any completed examinations or tests. For your security, all provided information will be encrypted upon submission and transit.

The estimated time required to complete this survey is 15-20 minutes.

COVID-19 Notice

Should you be experiencing symptoms of COVID-19 such as cough, congestion, fever, nausea, or diarrhea, please contact your healthcare provider immediately and alert RejuvinAge staff so we may reschedule your clinic appointment.

Please note: Masks are required for all patients entering RejuvinAge. If you do not have a mask, please alert our staff prior to arrival and one will be provided for you. We also ask that patients sanitize hands before entering and maintain 6ft social distancing while on premises.