🔒 APPOINTMENT REQUEST FORM

COMPLETE THE FORM BELOW TO REQUEST YOUR FREE CONSULTATION

Full Name *

Email *

Phone *

Which Products Are You Interested In?

How soon would you like to start treatment?

Do you currently reside in Arizona? (We can only ship to AZ addresses)

Yes

I acknowledge and agree to the Terms and Conditions and provide my express written consent to receive phone calls, SMS/MMS text messages, emails, and other forms of communication—including via automated technology—from AZTRT LLC & Arizona TRT LLC, even if my number is listed on a federal or state Do Not Call registry.

AZTRT LLC does not prescribe or dispense medication. All treatment decisions, including prescriptions, are made solely by licensed medical providers based on medical necessity and clinical judgment. Medication is only prescribed when deemed appropriate by a provider following a consultation and review of lab results.

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Arizona Licensed Providers

Support: (480) 852-5600 | [email protected]