Chattanooga  423.414.9400 |
Savannah  912.450.5454

Forms

Form Downloads

Click the PDF to begin the download

Patient Intake Form

For quicker service, please print and complete this before your scheduled appointment.

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SHIM Score

This questionnaire can help determine if you have erectile dysfunction, and, if so, the severity.

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Our Mission

Livewell Men’s Clinic is a medical facility to treat sexual dysfunction. Livewell will apply the latest medical technologies to allow clients to have the most satisfying sex life possible. We consider it an honor that patients allow us to help with their most intimate and sensitive issues. As such we pledge to handle these issues with the professionalism and discretion that is expected from a physician.