For Women: New Patient BioTe BHRT Forms

• New Patient Consultation Form
• Virtual Care Consent Form
• BioTE – Female Intake Form
• BioTE – Female Symptom Survey
• Hypothyroid Symptom Survey
• Hyperthyroid Symptom Survey
• BioTE Consent Form (to be completed in person at your appoinment)

Optional for women (please complete if symptoms apply):

• QUID – Urinary incontinence / Leaking Questionnaire

---

For Men: New Patient BioTe BHRT Forms

• New Patient Consultation Form
• Virtual Care Consent Form
• BioTE – Male Intake Form
• BioTE – Male ADAM Survey
• EDIS Survey
• Thyroid Symptom Checklist
• BioTE Consent Form – Male

---

BioTe Post-Pellet Instructions

For Women

For Men

---

Other

• Advanced HRT Symptom Survey
• Photo/Video Consent Form
• Governing Law and Jurisdiction Form
• Lipdissolve Consent Form