• AMS Questionnaire

    Pre-Consultation Questionnaire
  • Are you currently taking any testosterone treatment?*
  • Testosterone Treatment

  • If you are taking an injectable testosterone, which one are you taking?
  • If you are taking a Testosterone Cream, which one are you taking?
  • AMS Questionnaire

  • This is a standardised international questionnairre called the Ageing Male Sympton Questionnaire.  It is used to determine the if you might have symptoms due to decreasing Testosterone levels.  Please indicate which of these symptoms apply to you AT THIS TIME:

  • Irritability (feeling aggressive, easily upset about little things, moody)
  • Please go back to these seventeen questions and add up your score for all of them.

  • Please indicate your score here

    • 17-26 No symptoms related to decreased testosterone levels
    • 27-36 Little symptoms, possibly related to decreased testosterone levels
    • 37-49 Moderate symptoms, possibly related to decreased testosterone levels
    • >50 Severe symptoms, most likely related to decreased testosterone levels



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