Hormone Replacement Therapy Program Protocol Diary

Monitoring Program: Please take a moment and save this Microsoft Word document on your local computer.  The purpose of this is to track your health and wellness goals daily in diary form.

Please write the dates next to the Week # and the date and times, for each day of the week when documenting items.

Record: medication used, how much and at what time, your diet (what you ate), work hours and exercise for the particular day. Note in this document any other issues which may be of concern for your personal health representative.

Week 1:

• Monday:
• Tuesday:
• Wednesday:
• Thursday:
• Friday:
• Saturday:
• Sunday:

Week 2:

• Monday:
• Tuesday:
• Wednesday:
• Thursday:
• Friday:
• Saturday:
• Sunday:

Week 3:

• Monday:

• Tuesday:
• Wednesday:
• Thursday:
• Friday:
• Saturday:
• Sunday:

Week 4:

• Monday:
• Tuesday:
• Wednesday:
• Thursday:
• Friday:
• Saturday:
• Sunday:

Week 5:

• Monday:
• Tuesday:
• Wednesday:
• Thursday:
• Friday:
• Saturday:
• Sunday:

Week 6:

• Monday:
• Tuesday:
• Wednesday:
• Thursday:
• Friday:
• Saturday:
• Sunday:

Week 7:

• Monday:
• Tuesday:
• Wednesday:
• Thursday:
• Friday:
• Saturday:
• Sunday:

Week 8:

• Monday:
• Tuesday:
• Wednesday:
• Thursday:
• Friday:
• Saturday:
• Sunday:

Week 9:

• Monday:
• Tuesday:
• Wednesday:
• Thursday:
• Friday:
• Saturday:
• Sunday:

Week 10:

• Monday:
• Tuesday:
• Wednesday:
• Thursday:
• Friday:
• Saturday:
• Sunday:

Week 11:

• Monday:
• Tuesday:
• Wednesday:
• Thursday:
• Friday:
• Saturday:
• Sunday:

Week 12:

• • Monday:
  • Tuesday:
  • Wednesday:
  • Thursday:
  • Friday:
  • Saturday:
  • Sunday:

Reference

https://products.office.com/en-us/word

Contact Us Today For A Free Consultation

Name *

Email *

Phone *

Your Program *HGH TherapyHGH InjectionsTestosterone InjectionsCo-Created ProgramTestosterone TherapyAt Home HRT ProgramSermorelin InjectionsIpamorelinPeptidesWeight ManagementHuman Growth HormoneShort Height TherapyGender DysmorphiaBlood ServicesTesamorelinOther

Your State *United StatesAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWashington,DCWest VirginiaWisconsinWyomingCanada

Select Age (30+ only) *Over 2930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475+

* Required

Dear Patient,

Once you have completing the above contact form, for security purposes and confirmation, please confirm your information by calling us.

Please call now: 1-800-380-5339.

Welcoming You To Our Clinic, Professor Tom Henderson.