BHRT Online Forms

/BHRT Online Forms
BHRT Online Forms2018-03-08T14:59:34-07:00

Now you can fill out your Confidential Medical History and Patient Symptom Survey online!  You can also request a Free BHRT consultation. Please fill out the forms to the best of your ability and if the question is not applicable, type none.  After submission, you will receive a Confirmation and an Email with a PDF of your filled out forms. Our professional staff will contact you within 2 business days.

Contact Info

3006 Esplanade, Suite I, Chico, CA 95973

Phone: 530.345.7979, Toll Free-866.586.4633

Fax: 530.345.9797