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FAQ
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ADAM Questionnaire
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ADAM Questionnaire
ADAM Questionnaire
ADAM Questionnaire for Men
"
*
" indicates required fields
Step
1
of
4
25%
1. Do you have a decrease in libido (sex drive)?
*
Yes
No
2. Do you have a lack of energy?
*
Yes
No
3. Do you have a decrease in strength and/or endurance?
*
Yes
No
4. Have you lost height?
*
Yes
No
5. Have you noticed a decreased "enjoyment of life?"
*
Yes
No
6. Are you sad and/or grumpy?
*
Yes
No
7. Are your erections less strong?
*
Yes
No
8. Have you noticed a recent deterioration in your ability to play sports?
*
Yes
No
9. Are you falling asleep after dinner?
*
Yes
No
10. Has there been a recent deterioration in your work performance?
*
Yes
No
Name
*
First
Last
Email
*
Phone
*
Date of Birth
*
MM slash DD slash YYYY
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