Complete and receive your FREE Testosterone blood test Your Name: Your Email: City: State: ZIP: Phone: 1. Do you have a decrease in Libido (sex drive)? YesNo 2. Do you have a lack of energy? YesNo 3. Have you lost height? YesNo 4. Have you noticed a decreased "enjoyment of life"? YesNo 5. Do you experience mood swings? YesNo 6. Are your erections less strong? YesNo 7. Have you noticed a recent deterioration in your ability to play sports? YesNo 8. Have you noticed a decrease in strength and/or endurance? YesNo 9. Do you tire easily? YesNo 10. Has there been a deterioration in your work performance? YesNo 11. Do you experience sleep apnea? YesNo 12. Have you experienced a loss of muscle mass? YesNo Enter the Following Digits