1.Murray Hill National is conducting a study on the topic of Low Testosterone and would like your opinions to be included. If you qualify for this study, we are offering an incentive to participate. Please be assured that we are not selling anything and the information we gather will remain confidential and be used for research purposes only. We have a few questions to ask before providing more details and determining if you qualify to participate. By signing up for this paid research you are automatically joining our database and could be contacted for other paid studies. We do have an opt out option however it could take some time to be removed from the database and active panel.

Name

Company

Address

City/Town

State/Province

Zip/Postal Code

Country

Email address

Phone number

Job Title

Industry

2.What is your age?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

3.Are you...?

Male

Female

Other

4.Which of the following types of medications have you taken in the past 12 months? Please select all that apply

Topical testosterone gel/solution (testosterone applied to the skin)

Testosterone injection

Nasal testosterone (testosterone administered nasally)

Oral testosterone pills

Testosterone implant

Other form of testosterone (please specify)

5.What is the name (or names) of the testosterone medication you have used within the last 12 months?

6.How did you get your current prescription for testosterone?

I saw a doctor in-person

I used an app/online service such as Hims, Ro, Fountain TRT, PeterMD, TRT Nation, Maximus, Henry Meds, Rex Med, Amazon One medical, etc.

7.Which of the following conditions have you been diagnosed with by a doctor? Please select all that apply

Arthritis

Type 2 diabetes

Low or no testosterone, Testosterone Deficiency or Hypogonadism

High blood pressure (hypertension)

High cholesterol

Obesity

Depression or anxiety

None of the above

Other (please specify)

8.When were you first diagnosed with low or no testosterone?

Within the last 6 months

6-12 months ago

1-3 years ago

More than 3 years ago

9.What medical conditions did your doctor mention as the cause of low or no testosterone in your body?

Genetic condition (e.g., Klinefelter Syndrome, Kallmann syndrome)

Infection (e.g., Mumps orchitis)

Damage from radiation

Damage from Chemotherapy

Injury or trauma to the groin or reproductive area (e.g., testicular torsion)

Surgery to remove the testicles

Chronic kidney disease

Liver disease

Other (please specify)

10.What type of health insurance do you currently have? Please select your main insurance.

Commercial / Private (e.g., part of employer-sponsored plan, through state’s Marketplace, or other insurance provided by private, non-government insurer)

Medicare

Medicaid

No insurance / cash-paying

VA/Tricare

Other (please specify)

11.Which of the following best describes your race and/or ethnicity?

American Indian or Alaska Native

Asian or Asian American

Black or African American

Hispanic or Latino

Middle Eastern or North African

Native Hawaiian or other Pacific Islander

White

Another race

12.Are you willing and able to provide proof of diagnosis or photo verification if requested?

Yes

No

13.How do you receive your current testosterone prescription?

I get it shipped to my home

I go in-person to a pharmacy to pick it up