Nelson Vergel
Founder, ExcelMale.com
By Nelson Vergel | ExcelMale.com
Your first appointment with a new doctor is one of the most important medical encounters you will have. It sets the tone for the entire relationship. And yet, most men walk in unprepared. They forget medications, guess at dosages, blank on family history, and leave without asking what they came to ask.
I built this questionnaire after decades of coaching men on testosterone replacement, hormone optimization, and general health. It covers everything a thorough clinician would want to know before making a single recommendation. If you fill it out before your visit, you turn a rushed 15-minute appointment into a focused, productive conversation.
A doctor can only be as good as the information you bring. Walk in prepared, and you change the entire dynamic of the visit.
Personal information and contact details. Name, address, age, height, weight, waist and neck measurements, recent weight changes, body composition shifts.
Your primary goal. What outcome do you want from this consultation? Writing this down in advance forces you to clarify your own thinking.
Past medical history. Conditions you have now or had before, from anemia and arthritis to HIV, kidney disease, and thyroid problems.
Surgical history and hospitalizations.
Family medical history. Heart attacks, diabetes, cancers, strokes, and mental health conditions in your immediate family. Your doctor needs this.
Allergies and lifestyle. Smoking, alcohol use, substance use. Be honest here. Your doctor cannot help you if you leave things out.
Review of systems. A head-to-toe symptom checklist: headaches, vision changes, chest pain, shortness of breath, digestive issues, urinary problems, joint pain, fatigue, mood changes, sexual function, nipple sensitivity, hair loss, and more.
Current medications and supplements. Every prescription, over-the-counter product, vitamin, and supplement you take, with dosages.
Sleep quality assessment. How long it takes to fall asleep, how often you wake up, whether you snore, daytime drowsiness, and sleep apnea history.
Diet, exercise, stress, and mental focus. What you eat, how you train, how you sleep, and whether stress or brain fog are affecting your daily life.
Testosterone (Free, Bioavailable, and Total by LC/MS/MS)
Ultrasensitive Estradiol
DHEA-S
Comprehensive Metabolic Panel with eGFR
CBC with differential
Lipid Profile
Free T3, Free T4, and Ultrasensitive TSH (thyroid panel)
PSA (for men over 40)
Why these labs matter:
Most primary care doctors run a basic testosterone total and call it a day. That single number tells you very little. Free and bioavailable testosterone, estradiol, DHEA-S, and thyroid markers give a much clearer picture of what is actually happening in your body. Bring these results to your appointment and you skip weeks of back-and-forth with your doctor’s office.
You save time. Instead of spending 10 minutes filling out a clipboard in the waiting room, you use those 10 minutes talking about what actually matters.
You signal that you are serious. Doctors respond differently to patients who come in organized. It is human nature.
You catch things you would have forgotten. Sitting at home filling out a form, you have time to check your supplement bottles, look up that medication you started six months ago, and remember that your father had a heart attack at 55.
Bring it to your first appointment. If your doctor already has an intake form, bring this one too. The level of detail here goes far beyond what most clinics ask for, and that extra detail is exactly what leads to better diagnoses and better treatment plans.
You do not need to be scheduling a consultation with me to use this form. I originally designed it for my private coaching sessions, but the information it captures is useful for any medical appointment. Take it to your urologist, your endocrinologist, or your primary care doctor.
Download the Questionnaire (PDF):
Fill it out. Bring your labs. Show up prepared. It is the single easiest thing you can do to get better medical care.
Nelson Vergel is the founder of ExcelMale.com, author of Testosterone: A Man’s Guide and Built to Survive, and a men’s health advocate with over 40 years of experience in pharmaceutical consulting, patient education, and hormone optimization.
Your first appointment with a new doctor is one of the most important medical encounters you will have. It sets the tone for the entire relationship. And yet, most men walk in unprepared. They forget medications, guess at dosages, blank on family history, and leave without asking what they came to ask.
I built this questionnaire after decades of coaching men on testosterone replacement, hormone optimization, and general health. It covers everything a thorough clinician would want to know before making a single recommendation. If you fill it out before your visit, you turn a rushed 15-minute appointment into a focused, productive conversation.
A doctor can only be as good as the information you bring. Walk in prepared, and you change the entire dynamic of the visit.
What the Questionnaire Covers
The form is 11 pages. That sounds like a lot, but most of it is checkboxes and short answers. Here is what each section asks you to document:Personal information and contact details. Name, address, age, height, weight, waist and neck measurements, recent weight changes, body composition shifts.
Your primary goal. What outcome do you want from this consultation? Writing this down in advance forces you to clarify your own thinking.
Past medical history. Conditions you have now or had before, from anemia and arthritis to HIV, kidney disease, and thyroid problems.
Surgical history and hospitalizations.
Family medical history. Heart attacks, diabetes, cancers, strokes, and mental health conditions in your immediate family. Your doctor needs this.
Allergies and lifestyle. Smoking, alcohol use, substance use. Be honest here. Your doctor cannot help you if you leave things out.
Review of systems. A head-to-toe symptom checklist: headaches, vision changes, chest pain, shortness of breath, digestive issues, urinary problems, joint pain, fatigue, mood changes, sexual function, nipple sensitivity, hair loss, and more.
Current medications and supplements. Every prescription, over-the-counter product, vitamin, and supplement you take, with dosages.
Sleep quality assessment. How long it takes to fall asleep, how often you wake up, whether you snore, daytime drowsiness, and sleep apnea history.
Diet, exercise, stress, and mental focus. What you eat, how you train, how you sleep, and whether stress or brain fog are affecting your daily life.
Recommended Lab Work
The form also lists the lab tests I recommend having done before any hormone-related consultation. These are optional, but they make the conversation far more productive. The panel includes:Testosterone (Free, Bioavailable, and Total by LC/MS/MS)
Ultrasensitive Estradiol
DHEA-S
Comprehensive Metabolic Panel with eGFR
CBC with differential
Lipid Profile
Free T3, Free T4, and Ultrasensitive TSH (thyroid panel)
PSA (for men over 40)
Why these labs matter:
Most primary care doctors run a basic testosterone total and call it a day. That single number tells you very little. Free and bioavailable testosterone, estradiol, DHEA-S, and thyroid markers give a much clearer picture of what is actually happening in your body. Bring these results to your appointment and you skip weeks of back-and-forth with your doctor’s office.
Why Preparation Changes the Outcome
I have worked with thousands of men over 40 years of health advocacy. The ones who get the best care are not the ones with the best doctors. They are the ones who show up ready. When you hand your doctor a completed medical history form, three things happen:You save time. Instead of spending 10 minutes filling out a clipboard in the waiting room, you use those 10 minutes talking about what actually matters.
You signal that you are serious. Doctors respond differently to patients who come in organized. It is human nature.
You catch things you would have forgotten. Sitting at home filling out a form, you have time to check your supplement bottles, look up that medication you started six months ago, and remember that your father had a heart attack at 55.
How to Use This Form
Download the PDF using the link below. Print it out or fill it in digitally. Answer every section as completely as you can. Do not skip the parts that feel uncomfortable. Your doctor needs the full picture, not the edited version.Bring it to your first appointment. If your doctor already has an intake form, bring this one too. The level of detail here goes far beyond what most clinics ask for, and that extra detail is exactly what leads to better diagnoses and better treatment plans.
You do not need to be scheduling a consultation with me to use this form. I originally designed it for my private coaching sessions, but the information it captures is useful for any medical appointment. Take it to your urologist, your endocrinologist, or your primary care doctor.
Download the Questionnaire (PDF):
Fill it out. Bring your labs. Show up prepared. It is the single easiest thing you can do to get better medical care.
Nelson Vergel is the founder of ExcelMale.com, author of Testosterone: A Man’s Guide and Built to Survive, and a men’s health advocate with over 40 years of experience in pharmaceutical consulting, patient education, and hormone optimization.
