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Pharmacist and hormone specialist Tod Adams, R.Ph. would be happy to meet with you to discuss your hormone changes in a one-to-one setting. These private consultations cost $75 for 30 minutes and can give you the information you need to take control of your unbalanced hormones.

Before meeting with the pharmacist, you will want to complete our health questionaire, so he can reveiw your health history. Your information will be stored in your patient file and is not distributed to any third party.

There are two ways to fill out the form. The basic approach:

  • Download file by clicking here.
  • Print document.
  • Fill out document with black ink.
  • Fax form back to us at (859) 277-0252.
Or, you if you are more computer savy, or have more advanced software:
  • Download file by clicking here.
  • Save document to your computer and begin filling out the form using Adobe Acrobat.
  • Don't forget to save frequently....some older computers loose entered data.
  • Call us to at (859) 276-3905 for our best and current email address.

Don't have Adobe Acrobat Reader on your computer? You can download a user copy for free by visiting this site.