Wellness Nutrition Questionnaire
Do you have a lack of energy?
Do you have trouble sleeping?
Do you exercise once a week or more?
Do you have any of the following issues?
Do you have a history of any of the following?
Are you falling asleep after lunch/dinner?
Preferred method to be contacted?

 All Medical Care Should Include A Physical Exam By Your Primary Physician. If You Want Us To Do Your Physical Exam, We Can Arrange To Have It Done At Our Office

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Helping Men All Across Texas

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