• Call: (844) 569-8628
  • |
  • Get a Quote
  • |
  • COVID-19 Updates
  • |
  • Log In
DrChrono gray logo
  • Solutions
    • Providers
    • EHR by Specialty
    • Telemedicine
    • Large Practice
    • Small Practice
    • Multi Specialty

    • Patients
    • Patient Portal - OnPatient

    • Partners & Affiliates
    • Become a Partner
    • API Developers
    • Affiliate Information
    • Apple Mobility Program
  • Platform
    • Product
    • Electronic Health Records
    • Telehealth
    • Practice Management
    • Medical Billing
    • Revenue Cycle Management
    • Patient Portal
    • Mobile EHR Solutions
    • App Marketplace

    • Features
    • All Features
    • Lab & Imaging
    • eRx & EPCS
    • Medical Templates
    • Feature videos
  • Resources
    • Resources & Tools
    • Resources
    • Case Studies
    • Blog
    • Specialties
    • Testimonials
    • Webinars
    • Plans
    • ONC Certification

    • Customer Help
    • Support Center
    • Training videos
  • Company
    • About Us
    • Blog
    • Diversity
    • Life & Culture
    • Press
  • Telehealth
  • Try Now
DrChrono gray logo mobile menu icon
Close out of menu icon
  • Solutions
    • Providers
    • EHR by Specialty
    • Telemedicine
    • Large Practice
    • Small Practice
    • Multi Specialty

    • Patients
    • Patient Portal - OnPatient

    • Partners & Affiliates
    • Become a Partner
    • API Developers
    • Affiliate Information
    • Apple Mobility Program
  • Platform
    • Product
    • Electronic Health Records
    • Telehealth
    • Practice Management
    • Medical Billing
    • Revenue Cycle Management
    • Patient Portal
    • Mobile EHR Solutions
    • App Marketplace

    • Features
    • All Features
    • Lab & Imaging
    • eRx & EPCS
    • Medical Templates
    • Feature videos
  • Resources
    • Resources & Tools
    • Resources
    • Case Studies
    • Blog
    • Specialties
    • Testimonials
    • Webinars
    • Plans
    • ONC Certification

    • Customer Help
    • Support Center
    • Training videos
  • Company
    • About Us
    • Blog
    • Diversity
    • Life & Culture
    • Press
  • Try Now Log In
Low Estrogen - female
Hot flashes
Hot Flashes Day time_________# per week
Hot Flashes Night time_________# per week
Night sweats
Night Sweats _________# per week
Night sweats - areas
• • •
Vaginal dryness
Intercourse symptoms
• • •
Incontinence
Estrogen Dominant
Irregular periods
Menstrual Frequency
Menstrual Flow
Menstrual Pain/cramps
Uterine fibroids
Water retention
Tender breasts
Fibrocystic breasts
Increased forgetfulness
Foggy thinking
Tearful
Depressed
Mood swings
Adrenal Function
Stress
Morning fatigue
Afternoon Fatigue
Evening fatigue
Difficulty sleeping
Decreased stamina
Anxious
Irritable
Nervous
Ringing in ears
Fibromyalgia
Allergies
Headaches
Sugar cravings
Dizzy spells
Thyroid Function
Cold body temperature
Goiter
Hoarseness
Hair dry or brittle
Nails breaking or brittle
Constipation
Slow pulse rate
Rapid Heartbeat/Heart palpations
Metabolic Syndrome/High Androgen
Infertility problems
Acne
Increased facial hair/body hair
Scalp hair loss
Weight gain-hips
Weight gain-waist
High cholesterol
Elevated triglycerides
Low Androgen/Other
Decreased libido
Decreased muscle size
Thinning skin
Rapid aging
Aches and pains
Bone loss
Comments

Female Hormone Medical Form

Family Practitioner

There are 28 copies in use.
Published: June 28, 2021, 1 p.m.
Doctor: Dr. History Physical
Rating: +5   /

Use this form Back to list

Download Female Hormone

If you have an account, log in to use or rate this form. Log In

Click to use an int'l or other #

Don't have an account? Sign up to use this form. Sign Up

Close
DrChrono white logo

328 Gibraltar Dr
Sunnyvale, CA 94089

Call us: (844) 569-8628

Apple app store logo
  • Free EHR Demo
  • EHR
  • Practice Management
  • Medical Billing
  • Revenue Cycle
    Management
  • Patient Portal
  • Mobile EHR
  • eRx
  • Plans
  • EHR Features
  • Lab & Imaging
  • Patient Education Materials
  • Universities & Schools
  • Security Policy
  • SSO Log In
  • EHR Checklist
  • Meaningful Use
  • EPCS
  • MACRA & MIPS
  • ICD-10 Info
  • Share your Experience
  • OnPatient Portal
  • OnPatient Terms of Use
  • OnPatient Privacy Policy
  • Security Policy
  • Support Center
  • Developer API & SDK
  • EHR FAQ
  • Medical Billing Calculator
  • Medical Form Library
  • Insurance Lookup
  • ICD & HCPCS Lookup
  • App Directory
  • About Us
  • News & Updates
  • Careers
  • Contact Us
  • Testimonials
  • Logos & Branding
  • Our Flickr
  • Press
© Copyright 2019 DrChrono Inc.
  • Privacy Policy
  • Terms of Use
  • Site Map
  • twitter icon
  • facebook icon
  • youtube icon