Skip to main content
Close Search
Moore Health
Account
0
Menu
Hair Loss
Sexual Health
Testosterone
FAQ
About
A
c
c
o
u
n
t
0
was successfully added to your cart.
Moore Health
We are here to help.
What affects your daily life?
Select all that you relate to
Having a lack of energy
Feelings of being sad and/or grumpy
A decrease in libido? (sex drive)
A decrease in strength and/or endurance
Falling asleep earlier at night
Select all that you relate to
Does this sound familiar to you?
Select all that you relate to
A decrease in your ability to play sports
A deterioration in your work performance
A reduction of your erection strength
A decrease in strength and/or endurance
A decrease in height
Select all that you relate to
Our team will be in touch with you shortly
Name
(Required)
First Name
Last Name
Email
(Required)
Enter Email
Confirm Email
Password
(Required)
Enter Password
Confirm Password
Date of Birth
(Required)
YYYY slash MM slash DD
Required for Physcian Requisition
Do you have a Health Card
Select
Yes
Will provide later
No
CPSO Guidelines
OHIP #:
Can be provided at a later date.
OHIP Version Code:
Two letter unique identifier
Provincial Confirmation
I confirm to be in the province of Ontario when receiving treatment.
Close Menu
Hair Loss
Sexual Health
Testosterone
FAQ
About