Inanna Men’s Clinics Adam LowTestosterone Quiz Book Appointment Take The ADAM Quiz Please complete this questionnaire to help quantify the severity of hypogonadism (Low Testosterone). You will receive a score at the end based on your answers selected to determine your overall wellbeing. Step 1 of 4 25% Q1: Do you have a decrease in libido (sex drive)?(Required) Yes No Q2: Do you have a lack of energy?(Required) Yes No Q3: Do you have a decrease in strength and/or endurance?(Required) Yes No Q4: Do you have a decrease in strength and/or endurance?(Required) Yes No Q5: Have you noticed a decreased ‘‘enjoyment of life’’?(Required) Yes No Q6: Have you noticed a decreased ‘‘enjoyment of life’’?(Required) Yes No Q7: Are your erections less strong?(Required) Yes No Q8: Have you noted a recent deterioration in your ability to play sports?(Required) Yes No Q9: Are you falling asleep after dinner?(Required) Yes No Q10: Has there been a recent deterioration in your work performance?(Required) Yes No Q11: How would you rate your libido (sex drive)?(Required) Terrible Poor Average Good Excellent Q12: How would you rate your energy level?(Required) Terrible Poor Average Good Excellent Q13: How would you rate your strength/endurance?(Required) Terrible Poor Average Good Excellent Q14: How would you rate your enjoyment of life?(Required) Terrible Poor Average Good Excellent Q15: How would you rate your enjoyment of life?(Required) Terrible Poor Average Good Excellent Q16: How strong are your erections? (1= extremely weak 5= extremely strong)(Required) 1 2 3 4 5 Q17: How would you rate your work performance over the past 4 weeks?(Required) Terrible Poor Average Good Excellent Q18: How often do you fall asleep after dinner?(Required) Never 1-2/week 3-4/week 5-6/week Every Night Q19: How would you rate your sports ability over the past 4 weeks?(Required) Terrible Poor Average Good Excellent Q20: How much height have you lost?(Required) 2” or more 1.5-1.9” 1-1.4” 0.5-0.9” none-0.4” Name(Required) Email(Required) To book a FREE consultation to learn more about treatment for your concerns, please enter your PHONE NUMBER below: LET US HELP! Name Email Address Services ServicesERECTILE DISFUNCTIONPEYRONIE'S DISEASEPLATELET RICH PLASMATESTOSTERONE REPLACEMENTPRP FOR HAIR RESTORATIONPRIAPUS TOXIN Phone Number Message Send Message
