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Are you having symptoms of menopause?

Are you having cognitive symptoms of menopause?

CleopatraRX and the PearlPAK treatment may not be right for everyone. We want to make sure that you are safe and that this medication is right for you. In order to best understand the fit, please respond to the following.

I attest that I am biologically female.

I confirm that I am NOT currently pregnant nor am I trying to get pregnant.

I confirm that I am NOT being actively treated for or do NOT have a history of breast cancer, uterine cancer or ovarian cancer. (an abnormal pap smear is unrelated to cancers noted in this question and does not apply)

I confirm that I do NOT have a history of heart attack, stroke and/or blood clots.

I confirm that I do NOT have a history of liver disease, endrocrine disease or other serious illness.

When was your last gynecologist visit?

I confirm that I have had a mammogram in the last 2 years AND there was no evidence of breast cancer. (dense breast and fibercystic disease is not related and does not apply)

Almost finished. Thank you for going through the questionnaire to make sure the physician has the information needed to prescribe the best solution for you. One last question.

In order to make sure the PearlPAK treatment is tailored to your specific needs, it's important to know whether or not you have a uterus. Please check one of the options below.

I confirm that I have my uterus and have NOT had a hysterectomy

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