Adam Questionnaire Welcome to your Adam Questionnaire First Name Last Name Email: Phone 1: Do you have a decrease in libido (sex drive)? YES NO Hint 2: Do you lack energy? YES NO 3. Do you have a decrease in strength and/or endurance? Yes NO 4: Have you lost height? YES NO 5: Have you noticed a decreased “enjoyment of life”? YES NO 6: Are you sad and/or grumpy? YES NO 7: Are your erections less strong? YES NO 8: Have you noted a recent deterioration in your ability to play sports? YES NO 9: Are you falling asleep after dinner? YES NO 10: Has there been a recent deterioration in your work performance? YES NO Time is Up! Time's up
