FORMS

Biote Medical Female New Patient Package

The contents of this package are your first step to restore your vitality.

Please take your time to read this carefully and answer all the questions as completely as possible.

Thank you for your interest in BIoTE Medical. In order to determine if you are a candidate for bio-identical testosterone pellets, we need laboratory and your history forms. We will evaluate your information prior to your consultation to determine if BIoTE Medical can help you live a healthier life. 

Please complete the following tasks before your appointment:

2 weeks or more before your scheduled consultation: Get your blood labs drawn at any Quest Diagnostics or LabCorp. If you are not insured or have a high deductible, call our office for self-pay blood draws. We request the tests listed below. It is your responsibility to find out if your insurance company will cover the cost, and which lab to go to. 

Please note that it can take up to two weeks for your lab results  to be received by our office.

YOUR BLOOD WORK PANEL MUST INCLUDE THE FOLLOWING TESTS:

____________Estradiol

____________FSH

____________Testosterone Total

____________TSH

____________T4, Total

____________T3, Free

____________T.P.O. Thyroid Peroxidase

____________CBC

____________Complete Metabolic Panel

____________Vitamin D, 25-Hydroxy (Optional)

____________Vitamin B12 (Optional)

____________LipI’d Panel (Optional) (Must be a fasting blood draw to be accurate)

Female Post Insertion Labs Needed at 4,6 or 8 Weeks based on your practitioners choice:

___________FSH

___________Testosterone Total

___________CBC

___________Lipid Panel (Optional) (Must be a fasting blood draw to be accurate)

___________TSH, T4 Total, Free T3, TPO (Needed only if you’ve been prescribed thyroid medication)

___________Estradiol

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 885 Highway 138W. Stockbridge, GA.  30281 (470-377-2552) |  All Rights Reserved 2017