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1. Initial consultation with staff
   1. Discuss benefits of therapy, client goals and costs.
   2. Client fills out assessment form, symptom sheet, and permission form.
   3. Lab Work to be drawn if client decides to proceed.

1. Estradiol, Progesterone, Testosterone (Free & Total), DHEA, Pregnenolone, TSH, free T3, and free T4             
2. Basic labs on patients who have not had basic lab work done in the past three months. CBC, CMP, TSH, A1C, Lipid Panel. [TSH will not be duplicated if basic +HRT labs are drawn together.]

1. 1. Schedule next visit after lab work results have returned.
2. Initiation of therapy with Nurse Practitioner 
   1. Discuss identified symptoms on assessment form
   2. Discuss lab results
   3. Give client plan of therapy
   4. Educate client on goals and expectations
   5. Send hormone therapy prescription to pharmacy (amount for one month only)
   6. Appointment made for 1 month
3. Follow-up appointment #1 
   1. Client fills out another symptom form
   2. Results of therapy are discussed
   3. Plan is discussed
   4. Testosterone and DHEA levels (and others if indicated) drawn for men
   5. Prescription sent for 1 month therapy for women
   6. 1 month prescription sent for male clients after results of lab values are received.
   7. Appointment made for 1 month later.
4. Lab work repeated every three months or when lab values or symptoms are unstable
5. Repeat appointments performed every 3 months after initiating 3 month prescription therapy.