Are you a Bio-Identical Hormone Replacement Therapy Candidate? Health Assessment for Women do or do not , there is no try How frequently do you experience the following symptoms?Depressed mood Never Rarely Sometimes Often Always Fatigue Never Rarely Sometimes Often Always Mental confusion Never Rarely Sometimes Often Always Decreased sex drive/libido Never Rarely Sometimes Often Always Sleep problems Never Rarely Sometimes Often Always Mood changes/Irritability Never Rarely Sometimes Often Always Migraine/severe headaches Never Rarely Sometimes Often Always Bloating and/or Weight Gain Never Rarely Sometimes Often Always Hot flashes and/or Night Sweats Never Rarely Sometimes Often Always Joint pain Never Rarely Sometimes Often Always Do you have a family history of:Heart disease Yes No Uncertain Diabetes Yes No Uncertain Osteoporosis Yes No Uncertain Alzheimer's disease Yes No Uncertain Breast Cancer Yes No Uncertain Please fill out the information below and a member of our team will contact you to review your results. Name Email Phone Comments/Questions ⓘ By completing this quiz and providing your email address, you are opting in to receive email communications from The Vein & Cosmetic Center of Tampa Bay. You may choose to opt-out of future email communications at any time. Communications through our website or via email are not encrypted and are not necessarily secure. Use of the internet or email is for your convenience only, and by using them, you assume the risk of unauthorized use.