Choose the Right Form
to Get Started
Select the option that best describes you below. Each form takes 3–5 minutes and goes directly to Dr. Rucker's clinical team for review.
Transfer Patients
Already on TRT with another provider and want to switch to Dr. Rucker? Use this form to transfer your care. We'll request your existing labs and get you set up quickly.
Non-Previous TRT Users
New to TRT and never been on therapy before? This is your starting point. Complete this profile so Dr. Rucker can review your health history before your consultation.
General New Patient Health Profile
Not sure which form applies to you? Use this general health profile to share your background, goals, and current health status with the Reverse Medical clinical team.
TRT Patient Check-In Form
Currently on a TRT program with Reverse Medical? Use this check-in form to report your current symptoms, request protocol adjustments, or flag any concerns with the clinical team.
Vet & First Responder TRT Profile
Active duty, veterans, police, fire, or EMS? This profile is designed specifically for you. Special discounts and dedicated care — complete this form to get started.
Peptide Profile
Interested in BPC-157, TB-500, NAD+, Tirzepatide, or other peptide protocols? Complete this profile so Dr. Rucker can determine the right peptide stack for your goals.
Not sure which form to pick?
Non-Previous TRT Users
Choose this if you have never been on testosterone therapy before and you specifically want to start a TRT program. This form is optimized for hormone optimization intake and goes directly to Dr. Rucker's TRT review queue.
General Health Profile
Choose this if you're interested in peptides, weight loss, general wellness, or you're not yet sure which program fits your goals. The clinical team will review your profile and recommend the right path.