Metabolic Syndrome - Insulin Resistance, Hormones & Healthy Weight
Please complete this form as thoroughly as possible.  Dr. Plank will be in touch to talk to you about what you've tried, your goals and your health concerns.
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What Is Your Primary Concern? *
Do you have? *
Do you suspect you have hormonal imbalances? *
If you do suspect hormonal imbalances, why?  Common causes for women are: hot flashes, monthly cycle irregularity, past use of birth control, vaginal dryness, loss of interest in sex.                                                          For men hormone causes are: feeling weaker, less physical stamina, not as strong, loss of interest in sex.
How much weight would you like to lose? *
Would You like to talk to Dr. Plank about your health concerns?  If yes, please complete the following questions.  Thank you and let's talk soon! *
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Days and Times You Are Available to Talk to Dr. Plank
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