Patient Forms

Prior to all intitial consultations, please complete the appropriate intake form below. Following your form submission, a BHH practitioner will be in touch to schedule your virtual appointment. For any questions, please visit our FAQ page, or contact 515-587-8649.

*Balanced Hormone Health is not a compounding pharmacy. BHH partners with accredited compounding pharmacies in the U.S.

Patient Forms

WEIGHT-LOSS CLIENT INTAKE FORM

FEMALE HORMONE REPLACEMENT CLIENT INTAKE FORM

REQUEST FORM FOR LABS

WEIGHT-LOSS CLIENT FOLLOW-UP / REFILL FORM

MALE TRT CLIENT INTAKE FORM

TRT AND BHRT REFILL REQUEST FORM