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LET’S START WITH YOUR DETAILS

We’ll use this to send your results and book your consultation.
This assessment takes approximately 5 minutes to complete.

First name

Last name

Email

Phone

What type of work do you do?

Date of Birth

DD / MM / YYYY

Day

Month

Year

Height (cm)

Weight (kg)

Your BMI --

UnderweightHealthyOverweightObeseSeverely Obese

SHIPPING ADDRESS

Shipping address for prescribed medication delivery

Street Address

City / Suburb

State

Postcode

Country

WHAT’S YOUR PRIMARY GOAL?

Select the one that matters most to you right now.

Which symptoms are you experiencing?

Select all that apply to you.

Symptoms

How long has this been going on?

Select one option.

What's your main goal right now?

Select the one that matters most.

CURRENT MEDICATIONS

This helps us ensure safe treatment options.

Are you taking any prescription medications?

Any supplements, hormones, or peptides?

MEDICAL CONDITIONS

Select any that apply to you.

Liver conditions?

Kidney disease?

Cardiovascular disease?

Chronic pain conditions?

Mental health conditions?

Currently being treated?

Sleep apnoea?

LIFESTYLE & SUBSTANCE USE

Do you smoke or vape?

Recreational drug use?

Do you consume alcohol?

How many standard drinks per week?

ACTIVITY & EXERCISE

What's your activity level at work?

How often do you exercise?

What type of exercise?

SLEEP & RECOVERY

How many hours of sleep per night?

Any sleep difficulties?

Do you use any sleep aids?

BLOOD TEST HISTORY

TRT requires blood test verification.

Our panel is more comprehensive than a standard GP hormone test and includes:

Total & Free Testosterone
SHBG
LH & FSH
Oestradiol (E2)
Prolactin
PSA
Full Blood Count (FBC)
Lipid Profile
Liver Function (LFTs)
HbA1c

Blood tests must be within the last 90 days (12 weeks) to be valid for TRT assessment.

Have you had blood tests in the past 12 weeks?

Were they taken before 10am?

Were they taken fasting?

Have you had two separate low testosterone results?

TRT CONTRAINDICATIONS

Have you ever been diagnosed with any of the following?

CURRENT TRT STATUS

Are you currently on TRT?

Upload your pre-TRT blood results (optional)

This helps our doctors understand your baseline levels.

Click to upload

FERTILITY CONSIDERATIONS

TRT can affect fertility. Please answer honestly.

Are you planning to conceive in the next 12-18 months?

Have you previously fathered a child?

Do you understand that testosterone can suppress fertility?

Would you like to discuss fertility-preserving options?

BLOOD TEST UPLOAD

Upload your testosterone blood test results.

Do you have testosterone bloods from the last 12 weeks?

Upload your blood test results

PDF or images accepted (max 10MB).

Click to upload

NUTRITION

Do you track calories or macros?

What best describes your diet?

ALMOST DONE!

Just a couple more questions.

Support & Check-ins

We generally check in with all patients every 6 weeks to let the medication settle in, but you'll always have contact with us if you need it sooner.

Anything else the clinical team should know? (Optional)

IDENTITY VERIFICATION

Required for telehealth prescriptions in Australia. Your details are encrypted and stored securely.

Medicare Card Details

Medicare Card Number

IRN (Reference Number)

Expiry Date

Photo ID (Driver's Licence)

Upload a clear photo of the front of your driver's licence. This is used to verify your identity for prescription medications.

Click to upload photo

JPG, PNG or HEIC (max 10MB)

How much weight do you want to lose?

What have you tried so far?

Select all that apply.

Previous approaches

Any of the following apply?

WHAT LEVEL OF SUPPORT WORKS FOR YOU?

CURRENT MEDICATIONS

This helps us ensure safe treatment options.

Are you taking any prescription medications?

Any supplements, hormones, or peptides?

MEDICAL CONDITIONS

Select any that apply to you.

Liver conditions?

Kidney disease?

Cardiovascular disease?

Chronic pain conditions?

Mental health conditions?

Currently being treated?

Sleep apnoea?

LIFESTYLE & SUBSTANCE USE

Do you smoke or vape?

Recreational drug use?

Do you consume alcohol?

How many standard drinks per week?

ACTIVITY & EXERCISE

What's your activity level at work?

How often do you exercise?

What type of exercise?

SLEEP & RECOVERY

How many hours of sleep per night?

Any sleep difficulties?

Do you use any sleep aids?

NUTRITION

This helps us tailor the safest and most effective plan.

Do you track calories or macros?

What best describes your diet?

WEIGHT LOSS HISTORY

What have you previously tried for weight loss?

ALMOST DONE!

Just a couple more questions.

Support & Check-ins

We generally check in with all patients every 6 weeks to let the medication settle in, but you'll always have contact with us if you need it sooner.

Anything else the clinical team should know? (Optional)

IDENTITY VERIFICATION

Required for telehealth prescriptions in Australia. Your details are encrypted and stored securely.

Medicare Card Details

Medicare Card Number

IRN (Reference Number)

Expiry Date

Photo ID (Driver's Licence)

Upload a clear photo of the front of your driver's licence. This is used to verify your identity for prescription medications.

Click to upload photo

JPG, PNG or HEIC (max 10MB)

WHAT'S YOUR TOP PRIORITY RIGHT NOW?

WHAT WOULD YOU LIKE TO IMPROVE?

Select all that apply.

What's your training like right now?

WHAT'S HOLDING YOU BACK?

Select all that apply.

Openness to clinical support

WHAT TYPE OF INJURY ARE YOU DEALING WITH?

TELL US MORE ABOUT YOUR INJURY

How long has this been bothering you?

Pain level today: 5/10

No painSevere

Have you tried anything so far?

WHAT’S YOUR RECOVERY GOAL?

WHAT ARE YOU EXPERIENCING?

Select all that apply to you.

WHAT HAVE YOU TRIED SO FAR?

Select all that apply.

How long has this been going on?

WHAT DO YOU WANT TO ACHIEVE?

Select all that matter to you.

REVIEW & SIGN CONSENT

Please read the consent terms below. To continue, confirm your agreement and electronically sign.

TERMS AND CONDITIONS

Last updated: 28 December 2025

INTRODUCTION

Primal Zone Pty Ltd (ACN 667 681 263) (we, us or our) provides a telehealth technology platform which connects you with medical practitioners for the assessment and, where appropriate, the treatment and management of conditions related to hormonal health (Platform).

These Terms and Conditions apply to your access and use of our Platform. By accessing or using our Platform, you agree to these Terms and Conditions. If you do not agree to these terms, please do not access or use our Platform.

YOUR ACCOUNT

To access and use our Platform, you must register an account (Account). When you register, we will ask you for your personal and health information. You agree that any information you provide during registration and any updates to it will remain accurate and complete.

You must keep your Account details (including your login and password) confidential and must not share them with any third party. You are responsible for all activity on your Account. If you become aware of any unauthorised access to your Account, you must notify us immediately.

OUR SERVICES

Our Platform enables you to:

Complete online health assessments
Access telehealth consultations with Australian-registered medical practitioners
Receive prescriptions (where clinically appropriate)
Order medications for delivery
Access ongoing clinical support and monitoring

We do not provide medical advice directly. All medical decisions are made by independent, Australian-registered healthcare practitioners. Treatment is only provided where clinically appropriate and at the sole discretion of the prescribing practitioner.

ELIGIBILITY

You must be at least 18 years of age
You must be a resident of Australia
You must provide accurate and complete information during registration
You must have a valid Australian mobile phone number and email address
You must not use our Platform if you are prohibited from receiving medical treatment

YOUR RESPONSIBILITIES

Provide accurate and truthful health information
Disclose all relevant medical history and current medications
Follow medical advice and treatment plans as directed by your practitioner
Attend scheduled consultations and respond to follow-up requests
Report any adverse effects or concerns promptly to your practitioner
Keep your Account credentials secure and confidential
Not share prescribed medications with any other person
Not use our Platform for any unlawful purpose

PATIENT CONDUCT & PROFESSIONALISM

Primal Zone is committed to providing a safe and respectful environment for our medical practitioners and staff. We maintain a zero-tolerance policy for behaviour that is antagonistic, aggressive, or abusive. This includes, but is not limited to, any form of harassment, threats, or intimidation via email, phone, or the Platform. If a patient is deemed to have violated these conduct standards, we reserve the right to immediately terminate their Account, cease treatment, and, where necessary, pursue legal action.

MEDICAL PRACTITIONERS

Medical practitioners who provide services through our Platform are independent healthcare providers. They are registered with AHPRA (Australian Health Practitioner Regulation Agency) and maintain appropriate professional indemnity insurance.

We do not employ the medical practitioners. Each practitioner makes independent clinical decisions about your care based on the information you provide and their professional judgment.

FEES AND PAYMENT

You agree to pay all fees associated with the services you request through our Platform. Fees are displayed in Australian Dollars (AUD) and include GST where applicable.

Consultation fees: Cover your telehealth appointment with a medical practitioner.

Pathology fees: Paid directly to the pathology provider.

Medication costs: Additional to consultation fees and payable when you order medications.

Payment is required at the time of service unless otherwise specified. We accept major credit cards and other payment methods as displayed on our Platform.

CANCELLATION AND REFUNDS

You may cancel a scheduled consultation with more than 24 hours notice for a full refund. Cancellations with less than 24 hours notice may not be eligible for a refund.

Once a consultation has taken place, consultation fees are non-refundable as the service has been provided.

Medications that have been dispensed and shipped cannot be returned or refunded due to health and safety regulations.

Please refer to our Refund Policy for full details.

INTELLECTUAL PROPERTY

All content on our Platform, including text, graphics, logos, images, software, and any other material (Content), is owned by us or our licensors and is protected by copyright, trademark, and other intellectual property laws.

You may not reproduce, distribute, modify, create derivative works from, publicly display, or otherwise use any Content without our prior written permission.

PRIVACY

We collect, use, and disclose your personal and health information in accordance with our Privacy Statement. By using our Platform, you consent to our collection and use of your information as described in our Privacy Statement.

LIMITATION OF LIABILITY

To the maximum extent permitted by law, we exclude all liability for any loss or damage arising from your use of our Platform, including (but not limited to):

Any indirect, incidental, special, consequential, or punitive damages
Any loss of profits, revenue, data, or goodwill
Any reliance on information provided through our Platform

Our total liability for any claim arising from these Terms or your use of our Platform shall not exceed the amount you paid to us in the 12 months preceding the claim.

Nothing in these Terms excludes or limits any consumer guarantees or rights you may have under the Australian Consumer Law that cannot be excluded by law.

INDEMNITY

You agree to indemnify and hold us harmless from any claims, losses, damages, liabilities, costs, and expenses (including legal fees) arising from:

Your use of our Platform
Your breach of these Terms
Your violation of any rights of another person
Any inaccurate or incomplete information you provide

TERMINATION

We may suspend or terminate your access to our Platform at any time, without notice, if we believe you have breached these Terms or for any other reason.

You may close your Account at any time by contacting us. Closing your Account does not affect any rights or obligations that arose before termination.

GOVERNING LAW

These Terms are governed by the laws of New South Wales, Australia. Any disputes arising from these Terms shall be subject to the exclusive jurisdiction of the courts of New South Wales.

CHANGES TO THESE TERMS

We may update these Terms from time to time. We will notify you of significant changes by email or through our Platform. Your continued use of our Platform after changes are posted constitutes acceptance of the updated Terms.

CONTACT US

For questions about these Terms and Conditions, please contact us:

Primal Zone Pty Ltd
Email: ignite@primalzone.com.au
Phone: 1800 774 625

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