Hormone Assessment | BeBalanced Centers

Choose one of the options below. Are you...*
- Still Menstruating
- Experiencing Irregular Cycles
- Without a Period for Over a Year
- None of the above [male]
Do you feel like you want to lose weight?*
- Yes
- No

Do you have a symptom like low energy that may relate to your thyroid? Click if so.
- Low energy daily
Do you have any symptoms that may relate to lowered estrogen? Click on all that apply.
- Lack of Libido
- Vaginal dryness
Do you have a symptom that may relate to your thyroid? Click all that apply.
- Low energy daily
- Hair loss/male pattern balding

Has a doctor diagnosed you with any of these conditions? Click on all that apply.
- Chronic fatigue or fibromyalgia
- Endometriosis or fibroids
- Ovarian tumor or cysts

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