Review of Systems
A quick checklist of symptoms you’ve noticed recently, organized by body system.
Need it now? Call 505-977-9174.
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Apex Men’s Health & Cardiometabolic Care
Patient Forms
Complete your intake forms securely before your telehealth visit. Each button opens our HIPAA-compliant patient portal. Nothing you enter is collected by this website.
General health history (all patients)
These help your clinician understand your health before your first visit.
Medical & Surgical History
Past and current health conditions, hospital stays, surgeries, and preventive care.
Need it now? Call 505-977-9174.
Family History
Health conditions in your parents, brothers and sisters, and children, such as heart disease, diabetes, and cancer.
Need it now? Call 505-977-9174.
Medication & Allergy History
Prescriptions, over-the-counter medicines, supplements, past testosterone or performance products, and allergies.
Need it now? Call 505-977-9174.
Social & Lifestyle History
Tobacco, alcohol, sleep, exercise, diet, work, stress, and support at home, plus a brief mood check.
Need it now? Call 505-977-9174.
Apex intake screenings
Complete the screening that matches the reason for your visit. Screening forms don’t diagnose anything. Your clinician reviews your answers with you, and lab tests may be ordered at a lab near you.
Men’s Vascular Health
Heart and blood-vessel risk factors and erectile health. Erection changes can be an early sign of vascular disease.
Need it now? Call 505-977-9174.
Weight & Metabolic Health
Weight history, what you’ve tried before, your goals, interest in medicines such as GLP-1s, and sleep-apnea screening.
Need it now? Call 505-977-9174.
Testosterone (TRT) Screening
Low-testosterone symptoms, prior lab results, fertility plans, and safety questions to review before any testing or treatment.
Need it now? Call 505-977-9174.
Secure form links are coming soon. Until they’re live, call 505-977-9174 and we’ll send your forms through our secure patient portal. Please do not email health information; email is not a secure way to send it.
Good to know
Before your visit
Helpful to have ready
- Your medicine bottles or a current medication list
- Recent lab results, if you have them
- Home blood pressure readings, if you check them
- Your insurance card
- A private spot in New Mexico for your video or phone visit
About these forms
- Forms are completed in our secure patient portal, not on this website.
- For adults 18+ located in New Mexico. All visits are by telehealth.
- Testosterone is a federally controlled medication. Federal telehealth prescribing rules may require an in-person evaluation; we’ll explain your options at your visit.
- This practice does not provide behavioral health care. If a screening suggests a need, we’ll help connect you with resources.
If you are having a medical emergency, call 911 or go to the nearest emergency room. If you are in crisis or thinking about harming yourself, call or text 988.