Peak HRT Reviews for Women: What the $649 Visit Covers, What It Doesn't, and Who It Fits

Peak HRT reviews for women point to a well-liked local clinic with a $649 cash-pay, lab-first evaluation in Silverthorne, Colorado. None of the 14 on-site testimonials we read names menopause care, so confirm the medicine, ongoing cost and required in-person visits before you book.

Last updated: October 24, 2026

The HRT Index is the independent decision resource for online menopause and HRT care — comparing telehealth providers on clinical legitimacy, care quality, medication fit, price transparency, and access, with every claim verified and dated, so women can choose the path that fits their situation before their first consult.

This review covers Peak HRT & IV Drip Lounge (peakhrt.com), a local clinic at 358 Blue River Parkway in Silverthorne. Its women's pages do not explain remote-care arrangements. HRT means hormone replacement therapy. Looking for Peak Medical in Park City, Utah, or another "Peak" clinic? See which Peak this is.

Peak HRT is likely a good fit if you:

• Live in or near Summit County, Colorado, and can attend the appointments Peak confirms are required
• Want an unhurried, face-to-face visit, a broad blood panel and a body-composition scan
• Are in perimenopause, or have PMOS (polyendocrine metabolic ovarian syndrome, formerly PCOS), and want someone to look at the whole picture
• Can pay cash, or with an HSA or FSA card, once you have the full quote

Start somewhere else if you:

• Need remote care and cannot confirm that Peak's visit requirements work for your location
• Need insurance to pay for your visits
• Need the exact medicine and monthly price confirmed before paying, and Peak cannot give you that information
• Have unexplained vaginal bleeding, a past blood clot or stroke, or a history of breast or uterine cancer — begin with a gynecologist or menopause specialist

One thing to know up front. Peak publishes its first-visit price, which many clinics don't. What it doesn't publish is everything after that: the medicine, follow-up visits and repeat labs. Unknown isn't the same as unavailable. It just means you ask before you pay.

If you're local and that sounds like you, Peak's first step costs nothing. Its free 10-minute call is a good place to ask about price and medicine.

Prefer care from home and paying cash? Gala advertises a monthly HRT plan with prescription delivery. Confirm that its medication, full price and age/state availability fit before paying.

Affiliate link. We may earn a commission if you choose Gala. We earn nothing from Peak, and it doesn't change what we report. How we make money.

What we actually verified · Last verified October 2026

We read, on October 24, 2026: Peak HRT's homepage, Women's Hormone Therapy, PMOS, Hormone Optimization and About pages, booking page and Terms and Conditions (dated May 6, 2026); Peak's review profile on Birdeye; and primary menopause guidance and drug labeling listed in Sources.

We confirmed from Peak's published pages: Peak is a cash-pay clinic in Silverthorne, Colorado. It doesn't bill insurance directly and accepts HSA and FSA cards for eligible services. Women's hormone care starts with a $649 evaluation that includes a lab panel, a body-composition scan, a consultation and a treatment plan. A free 10-minute discovery call is offered. One prescriber is named, with provider-reported credentials: Rebecca Miskew, MS, APRN, A-GNP-C.

We did not: visit, book, pay, talk with Peak's staff or receive care. This is a documentation review, not a patient test.

We could not confirm: the monthly cost after the first visit, which hormone products Peak prescribes and whether they're FDA-approved or compounded, follow-up and repeat-lab fees, whether hormone care is available by video, the Google review count, or Ms. Miskew's license record.

On this page: Reviews · Who runs it · What it offers · Cost · Do you need the labs? · Medicines · Insurance and cancelling · If you're not local · Peak vs online care · Conflicts · Questions to ask · Health factors · How we reviewed · Quick answers

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Peak HRT reviews for women: what do patients actually say? {#reviews}

Peak's website and Birdeye displayed a 5.0 Google rating on October 24, 2026, but the accessible comments cover mixed services, including IV care and general visits. None of the 14 unique on-site testimonials explicitly mentioned menopause, hot flashes, estrogen or progesterone.

That isn't a knock on Peak. It's a limit on what the stars can tell you.

Here's what each place you might see a Peak rating actually counts.

What each Peak rating measures (checked October 24, 2026)

Where you see it	What it shows	What it actually counts	Useful for	Not useful for
Peak's website	"5.0 on Google," no count shown	Peak's own display of its Google rating	A sense of how visits feel	Judging menopause care
Peak's testimonial carousel	14 reviews, chosen by Peak	Hand-picked comments across all services	Tone of care	Typical results
Birdeye profile	5.0 stars from Google reviews	All services. The count shown changed between our checks the same day, so we don't quote one.	Staff kindness, speed, cleanliness	Hormone results
Google Maps	Not checked	All services	—	—

What patients praise

The comments repeat a few themes. Some reviewers describe unhurried visits and clear explanations. They praise the nurses' warmth. Several describe feeling better after IV care; those are individual service reports, not evidence of menopause-treatment results.

Of the 14 testimonials on Peak's site, we counted about four about IV or vitamin-shot visits, two that mention "Peak TRT" and the rest praising the provider, staff or labs in general. We didn't guess anyone's sex or what they were treated for when the review didn't say.

The one comment closest to your question comes from a reviewer named Andrea Uliano, whose testimonial appears on Peak's women's page. She says the provider "helped me understand my labs in a wholistic way." Peak chose to show that review. It also doesn't say she received hormone therapy — she mentions supplements.

The five Google-attributed excerpts visible on Birdeye during our check included IV care and general service comments; none described menopause treatment.

What's missing — and did we find complaints?

We didn't find an independent review from a woman describing menopause or perimenopause care at Peak, and we didn't find a public complaint. Both are limits of our search, not proof either way.

Three different questions get mixed together in reviews:

1. Was the visit pleasant? The excerpts we read describe positive visits.
2. Is ongoing care reliable? Refills, follow-ups and billing over months. The visible excerpts do not establish that.
3. Is the treatment right for my body? No review can answer this. A clinician can.

A clinic that also treats men and runs an IV lounge may not have many visible menopause reviews. We don't know when the clinic itself opened, and website-policy dates do not establish that.

What reviews can't tell you: whether a medicine is FDA-approved, what you'll pay each month, or whether a treatment is safe with your history. The rest of this page covers those.

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What is Peak HRT, and who runs it? {#which-peak}

Peak HRT is one in-person medical clinic in Silverthorne, Colorado, operated as Peak HRT LLC, doing business as Peak HRT & IV Drip Lounge. Its named prescriber is Rebecca Miskew, MS, APRN, A-GNP-C, a nurse practitioner who, according to Peak, has 16+ years of clinical practice and leads a small team of registered nurses.

Peak calls itself a "performance" clinic. Its homepage markets hormone optimization to men and women 30 and up, and it also offers medical weight loss, peptides, IV drips, mobile IVs, sauna, red light, compression therapy and body scans.

What Peak says about its people, and what we confirmed (October 24, 2026)

Question	What Peak says	Where	Our status
Company and address	Peak HRT LLC, DBA Peak HRT & IV Drip Lounge; 358 Blue River Pkwy, Suite D, Silverthorne, CO 80498	Footer, all pages	Published by Peak
Prescriber	Rebecca Miskew, MS, APRN, A-GNP-C; board-certified adult-gerontology primary care nurse practitioner	About	Provider-stated. We could not independently confirm current licensure or certification.
Experience	16+ years of clinical practice	Home, About	Peak's statement
Hormone training	"Certified in hormone replacement and peptide therapy"; certifying body not named	About	Not confirmed
Menopause-specific credential	None listed	—	Not established
Team	Registered nurses, a patient care coordinator and an EMT/nursing student	About	Peak's statement
Where licensed	Colorado	Home	Peak's statement
Who reviews your plan	The named provider reviews intake forms, labs and treatment plans before therapy begins	Home FAQ	Peak's statement

What those letters mean

• APRN means advanced practice registered nurse. A nurse practitioner (NP) is one kind. NPs can diagnose and prescribe.
• A-GNP-C is a board certification in adult-gerontology primary care: broad care for adults of all ages. It isn't a women's-health or menopause specialty.
• MSCP means Menopause Society Certified Practitioner. It's an extra credential for clinicians who pass a menopause exam. It isn't required to prescribe HRT, and Peak doesn't list it. If menopause expertise matters to you, ask about training.

You can check any clinician yourself. Colorado has a public license lookup, and The Menopause Society keeps a practitioner directory. The directory includes Society members as well as certified practitioners; check whether an individual listing shows MSCP certification.

A basic legitimacy check

A legitimate clinic should…	Peak
Require a medical evaluation before prescribing	Yes, by its description
Name the person who prescribes	Yes
Review your history before treatment	Stated
Offer follow-up	Yes — Peak describes quarterly check-ins and repeat labs
Say whether a medicine is FDA-approved or compounded	Not stated
Publish the cost of ongoing care	Not stated

That's four reasonable answers and two gaps. The gaps are about the medicine and the money. Ask for both by text before booking.

Which "Peak" is this?

Several hormone businesses use the word Peak. This review is only about Peak HRT in Silverthorne, Colorado (peakhrt.com).

• Peak Medical in Park City, Utah, is a separate company offering hormone therapy for men and women.
• Peak TRT & Wellness in Wesley Chapel, Florida, is a men's testosterone clinic.
• Some reviews of the Silverthorne clinic call it "Peak TRT." Those appear on Peak's own site, so they seem to refer to the same clinic.

We haven't reviewed the others. If you meant one of them, the questions on this page still work.

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What does Peak HRT offer women for perimenopause and menopause? {#offers}

For perimenopause and menopause, Peak describes a full lab evaluation and a personal plan that may include estrogen and progesterone, with added support such as nutrition and weight care. Peak separately offers PMOS care focused on hormonal and metabolic assessment. It doesn't name the hormone products, the forms (pill, patch, cream, pellet) or whether they're FDA-approved or compounded.

Quick definitions:

• Perimenopause is the transition around your last period, when hormones swing up and down. Symptoms can start in your late 30s or 40s.
• Natural menopause is confirmed after 12 months without a period, when no other cause explains it.
• Estradiol is one of your body's estrogens and a common form used in HRT.
• Systemic treatment (pills, patches, gels) travels through your bloodstream and treats hot flashes and night sweats. Local treatment (low-dose vaginal estrogen) stays mostly where you put it and treats dryness and pain with sex.

Peak's four steps, in its own description

1. Comprehensive evaluation. A hormone, thyroid and metabolic blood panel, a body-composition scan and a long consultation.
2. Personalized hormone therapy. Peak says hormone therapy, including estrogen and progesterone, can be safe and effective for many women when matched to the right person at the right time, and that it reviews real benefits and risks with you.
3. Beyond hormones. Plans may include body-composition, peptide, nutrition, sleep and recovery support.
4. Ongoing optimization. Peak says it monitors, re-tests and adjusts.

That second point matches mainstream menopause guidance, and we give Peak credit for saying it plainly.

What women might need, and what Peak lists

What you might need	Does Peak list it?	Product or form named?	Ask Peak
Systemic estrogen for hot flashes and night sweats	Estrogen mentioned	No	"Which product and form — pill, patch, gel, cream or pellet?"
Progesterone to protect the uterine lining	Mentioned	No	"If I have a uterus, how will my lining be protected?"
Vaginal estrogen for dryness, pain with sex or repeat UTIs	Vaginal dryness listed as a symptom	No	"Do you prescribe low-dose vaginal estrogen?"
Non-hormonal hot-flash treatment	Not mentioned	—	"If I can't take hormones, what do you offer?"
Testosterone for women	Not on the women's page (testosterone is listed for men)	—	See health factors
PMOS / metabolic care	Yes	—	"What do you test, and why?"
Peptides, IV drips, supplements	Offered clinic-wide	—	"Are these optional, and what do they cost?"

About PMOS. In May 2026, an international consensus published in The Lancet renamed polycystic ovary syndrome (PCOS) as polyendocrine metabolic ovarian syndrome (PMOS), to reflect its hormone and metabolism effects. Full adoption in guidelines is planned for 2028 (consensus paper abstract; Endocrine Society announcement). If you have PMOS and are also nearing menopause, see menopause HRT when you have PCOS.

About "optimization." Peak talks about looking beyond the normal lab range and restoring balance. The Menopause Society says saliva and urine testing are unreliable for choosing HRT doses, and blood hormone testing is rarely needed (position statement). Symptoms, treatment response and side effects matter more than chasing a target level. That doesn't mean Peak's care is wrong for you. It means it's fair to ask how your lab results will change your plan.

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How much does Peak HRT cost for women? {#cost}

Peak publishes one price for women's hormone care: a $649 first evaluation that includes a lab panel, a body-composition scan, a consultation and a treatment plan. It doesn't publish what medicine, follow-up visits or repeat labs cost after that, so any 90-day or yearly total is incomplete: at least $649, plus charges you'll need Peak to quote.

What the $649 includes

According to Peak's women's, hormone and booking pages (read October 24, 2026):

• A blood panel covering hormones, thyroid, metabolism, inflammation, heart and nutrient markers. One page says "40+ markers" and another says "50+."
• An InBody body-composition scan
• An in-depth consultation, listed as 60 minutes on the service and booking pages
• A personalized treatment plan

Peak's terms say payment is due at the time of service unless arranged otherwise. You can pay with a card, HSA or FSA, and Peak offers itemized receipts.

Peak's care-and-cost worksheet

This is what's known and what you'll need to ask.

Item	What Peak publishes	Status	Ask before you commit
Discovery call	Free, 10 minutes	Known	"What happens after the call?"
Initial evaluation	$649, one time	Known	"Is this the package for women's menopause care?"
Lab panel and visit length	40+ vs 50+ markers; 30 vs 60 minutes in different places	Conflicting	"Which tests and how much clinician time are in my $649?"
Prescription medicine	No price published	Unknown	"Which medicines would I pay for separately, and how much per month?"
Follow-up visits	"Quarterly check-ins" described; no fee	Unknown	"How often are visits required, and what does each cost?"
Repeat labs	"Lab re-tests" described; no fee	Unknown	"Which tests later, how often, and what do they cost?"
Extra specialty testing	Peak says it's only when clinically appropriate and priced before ordering	Case-dependent	"Is this optional, and would it change my plan?"
Pharmacy	Not stated	Unknown	"Can my prescription go to my own pharmacy?"
Membership or package	Peak's terms say packages and memberships follow their own purchase terms	Unknown	"Is any membership or minimum commitment required?"
If no prescription is right for you	Terms say completed services are generally nonrefundable	Likely no refund for the evaluation	"What do I pay if hormones aren't recommended?"
First 90 days	$649 + unknowns	Incomplete	"Please give me an itemized 90-day estimate."
After that	Can't be calculated	Incomplete	"Please separate recurring charges from occasional ones."

An unknown required charge isn't zero. It means the total isn't finished.

Not sure an in-person, lab-first clinic is the right first step for you? The right online menopause care isn't the same for every woman — it depends on your symptoms, what you've already tried, your age, your state and your health history. Some situations belong with an in-person clinician first. Use The HRT Index's Find My HRT Path tool to explore a featured care option for your situation — and to flag when online care isn't the right starting point — before your first consult.

It's free, takes about 60 seconds and doesn't ask for your email. It asks five questions and shows a featured online option or guidance. It doesn't diagnose anything or decide whether you should take hormones; a clinician does that. We may earn a commission from the providers it features, and that affects which ones appear. Here's how it works.

How Peak compares with other routes over the same time

Different services charge in different units: one evaluation, a monthly plan or a fee per visit. The fair way to compare is the money you'd pay over the same stretch of time. Here's that comparison with every known price and every gap shown.

First 90 days and first year, by route (USD; examples, not quotes)

Route	Care setting	Starting charge / due now	First 90 days	First year	Still unknown or extra	Insurance	Price checked
Peak HRT	Clinic in Silverthorne, CO	$649 evaluation; terms say payment at service unless otherwise arranged	At least $649 — incomplete	At least $649 — incomplete	Medicine, follow-ups, repeat labs	Not billed; HSA/FSA accepted	Oct 24, 2026
Gala HRT	Online, cash	Advertised $69/month; exact first charge and timing unconfirmed	Incomplete: confirm charge dates and everything included	Incomplete: confirm renewal dates, prescription and required extras	Labs if ordered; exact products and combination coverage; billing interval	Not billed; HSA/FSA accepted	Oct 24, 2026
Alloy	Online, cash, published menu	$49 consult; prescribed medicines charged separately after order approval	Incomplete: confirm first-order and refill dates; supply example below	Incomplete: confirm plan and renewal dates; supply example below	Prescribed doses, order price, billing dates and any required extras	Not billed	Oct 24, 2026
Midi Health (self-pay)	Online video	$250 first visit, charged after the visit; card required to book	$400 in visit fees if one $150 follow-up occurs, plus medicine and any ordered labs	$250 + $150 per follow-up in the period, plus medicine and any ordered labs	Medicine and any ordered labs billed separately	Check exact plan and state	Oct 24, 2026
Your own OB-GYN or a local menopause specialist	In person	Quoted visit charge or plan cost-sharing	Depends on care and your plan	Depends on care and your plan	Medicine, any ordered tests and follow-ups	Depends on clinician and plan	—

Source: Peak women's page; Gala's HRT landing page; Alloy; Midi. Published rates and arithmetic examples are not complete checkout quotes. Three calendar months, 90 days and the charges falling in either period can differ. Here, first year means the 12-calendar-month period from your start date.

Alloy supply example: At the published starting rates, a $49 consultation plus three months of estradiol pills and progesterone adds up to $237.97: $49 + ([$39.99 + $23] × 3). The consultation plus twelve months at those unchanged starting rates adds up to $804.88. Alloy generally supplies and bills treatment in three-month blocks. These are supply examples, not verified cash totals for the first 90 days or first year, and they exclude promotions (product menu; billing explanation).

Alloy renews by subscription. Confirm the next charge and shipment date before ordering. Its terms distinguish a seven-day subscription-cancellation notice from a five-business-day shipment-change notice, and consultation fees are nonrefundable.

What those numbers mean

Three Gala charges at its advertised $69 rate would total $207; Peak publishes a $649 initial evaluation. Neither establishes the complete first-90-day cost. That doesn't make Gala the better value for everyone. Peak's package lists an in-person visit, a broad blood panel and a body scan; Gala's advertised plan does not describe that same package. Gala's $69 is an advertised price, and it doesn't guarantee which medicine you'd get.

If you have good insurance, a covered visit plus a covered generic at your pharmacy can beat every cash price here. Ask Peak whether it can send prescriptions to your own pharmacy. Your drug coverage might apply even though the visits are cash.

Peak's real total depends on prices it hasn't published. Ask for them in writing before you book.

A worked example

Dana is a hypothetical reader. This example uses Peak's published evaluation price and leaves unpublished charges blank.

Dana is 49, lives in Frisco and has hot flashes and poor sleep. Peak lists a $649 evaluation. If her written quote later calls for twelve medicine charges of M, four additional follow-ups at V, and four repeat lab panels at L during her first year, with no other required fees, her calculation would be:

$649 + (12 × M) + (4 × V) + (4 × L)

Peak doesn't publish M, V or L, so Dana asks on the free call. Until the fees and timing are known, her known evaluation cost is $649, and her full first-year budget is incomplete. Quarterly check-ins do not, by themselves, tell her how many paid visits or lab draws fall within either period.

Online, Gala advertises $69 a month: $828 for twelve charges at that rate. Before using that as a first-year budget, Dana would confirm the exact medicine, amount and dates charged, and any required extras.

Copy this worksheet

MY HRT COST CHECK (keep this private)

Clinic or provider: ____________________   Date asked: __________
Start date: __________
First 90 days: start date through the day before start + 90 days
First year: start date through the day before its 12-month anniversary

Amount charged today: $______   What it covers: __________________
First visit / evaluation: $______   Charge date: __________
Medicine charge: $______ every ______   First / next charge dates: __________
Follow-up fee: $______   Number in first 90 days: ____   In first year: ____
Repeat-lab fee: $______  Number in first 90 days: ____   In first year: ____
Membership / package: $______ every ______   Minimum commitment: ______
Shipping / other required charges and dates: ______________________
Included in a price above (do not count twice): ___________________
If no prescription is right: I pay $______   Refund terms: __________

FIRST 90 DAYS = every required charge actually due in that window
FIRST YEAR = every required charge actually due in the stated year
Count included services once. List optional items separately.

For each item, mark: quoted / included / not required / unknown.
A required amount, date or count is unknown? My total is INCOMPLETE.
Do not turn a blank into $0, or annual visit counts into 90-day counts.

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Do you really need Peak's $649 evaluation before menopause hormone therapy? {#labs}

Peak's $649 evaluation is not a general requirement for starting menopause care. Routine hormone testing is not usually needed to diagnose menopause at the usual age or choose an HRT dose. Targeted tests can help when symptoms start before 45, when PMOS is suspected, or when another condition may explain your symptoms; that does not mean a broad hormone panel is needed.

Here's what The Menopause Society's position statement and Australasian Menopause Society diagnosis guidance say, in plain words (read October 24, 2026):

• Routine hormone tests are not usually needed to choose a menopause HRT dose. Symptoms, treatment response and side effects help guide care.
• Hormone levels change from day to day and hour to hour, so even a blood test is only a snapshot.
• Saliva and urine hormone tests are unreliable for choosing HRT doses; blood hormone testing is rarely needed for that purpose.
• An FSH test (follicle-stimulating hormone) can help in some unclear or early-menopause situations. Having no periods after a hysterectomy does not, by itself, show whether your ovaries have reached menopause.

So more labs aren't automatically better, and they aren't automatically wasteful. They're worth paying for when they answer a real question about you.

When targeted tests may help

Your situation	Will hormone labs likely change the plan?	Other labs that may matter	What it means for choosing Peak
Over 45, typical hot flashes or night sweats, periods slowing or stopped	Usually not	Routine health labs your own doctor may already order	A broad hormone panel is not usually required to start menopause care elsewhere. Choose Peak for the in-person relationship, not because labs are required.
Under 45 with menopause symptoms or periods stopping early	Often useful to assess early menopause or other causes	Thyroid, pregnancy testing or other targeted tests, per your clinician	Get a clinical assessment; ask which tests are needed.
Irregular cycles, acne, unwanted hair, weight that won't move (possible PMOS)	Often	Blood sugar testing and a cholesterol panel; routine insulin assays are not recommended	Peak's metabolic focus may fit. Ask what's tested and why.
No uterus and unsure whether you're in menopause	Sometimes, if knowing menopausal status would change care	—	Ask whether testing would answer a useful question in your case
Fatigue, hair thinning, feeling cold, mood changes	Targeted tests may help assess other causes	Thyroid tests, blood count or ferritin when the history suggests a need	Your own clinician may arrange targeted tests; check your plan's coverage.
Already on HRT and doing well	Not to chase a "target" level	Per your clinician	Ask how Peak would use lab results to change your dose

The PMOS testing row follows the international guideline published by ASRM; the other rows draw on the diagnosis and HRT guidance linked above. These are questions for your clinician, not a personal test order.

Two questions to ask any lab-first clinic:

• "Can you use results from labs I've had in the last few months?"
• "What will each test tell us, and how could it change my treatment?"

If you book, follow Peak's own prep instructions. It asks for a fasting morning draw and times the draw to your cycle if you still have periods.

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Does Peak HRT use FDA-approved or compounded hormones? {#medicines}

Peak's public pages don't say. Peak describes bioidentical hormone therapy, but "bioidentical" describes the hormone's shape, not whether the finished medicine is FDA-approved — so ask for the exact product name before you start.

Three terms, plainly:

• FDA-approved means the finished medicine — the actual pill, patch or gel — was reviewed by the U.S. Food and Drug Administration for safety, effectiveness and quality.
• Compounded means a medicine was mixed or altered to meet a patient's needs, commonly by a pharmacist or clinician. The FDA says compounded drugs aren't FDA-approved, and it doesn't check their safety, effectiveness or quality before they're sold (FDA).
• Bioidentical means the hormone has the same structure as the one your body makes. Many FDA-approved estradiol and progesterone products are bioidentical. So are many compounded ones.

The Menopause Society says custom-compounded hormones aren't safer or more effective than approved bioidentical ones (The Menopause Society). Compounding can still meet a real need, like a dose or ingredient that isn't sold commercially. The point is to know which one you're getting and why.

Pellets are small hormone implants placed under the skin. Peak's pages don't mention them. If someone offers them, ask what's in them, whether the finished product is FDA-approved, and how the dose is adjusted once it's placed. For a clinic built around pellets, see our HerKare review.

If you have a uterus

If you take systemic estrogen and still have a uterus, you need a progestogen (progesterone or a similar medicine) or another plan your clinician directs, to protect the uterine lining. The Menopause Society is clear on this. Low-dose vaginal estrogen is different, and doesn't usually need it. Ask Peak how your lining would be protected, especially if you're offered a cream. See who needs progesterone for menopause.

If the exact product is a dealbreaker

Some women will only take an FDA-approved product, or want a specific patch. That's reasonable. Ask Peak to name the product before you pay, or start with a service that publishes its menu up front.

Alloy publishes its HRT products and prices before you begin. We don't earn anything from Alloy.

For more, read compounded vs FDA-approved HRT and our FDA-approved HRT medication list.

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Does Peak HRT take insurance, HSA or FSA — and what if you cancel? {#insurance}

Peak doesn't bill insurance directly. It accepts HSA and FSA cards for eligible services and gives itemized receipts, which lets you use pre-tax money but isn't the same as your health plan covering the cost. Its terms require at least 24 hours' notice to change an appointment and say completed services are generally nonrefundable.

Peak says it chose cash-pay so it can offer longer visits and broader labs without insurance limits. That's a real tradeoff, and whether it's worth it depends on your plan.

Which camp are you in?

• PPO plan with low copays: check an in-network option first. Your own OB-GYN or Midi may cost less.
• High deductible or no insurance: cash routes compete on total cost. Use the table above.
• Medicare or Medicaid: Peak won't bill either. Midi says it cannot treat Medicaid or Medi-Cal patients, even as self-pay. Medicare beneficiaries may self-pay, but Midi says they cannot submit claims for its visits, medicines or related services. Start with your own covered clinician if coverage is essential.

HSA and FSA: Peak's terms say you're responsible for checking eligibility with your plan administrator. A receipt doesn't guarantee reimbursement.

Prescriptions: ask whether Peak can send your prescription to your usual pharmacy. Your drug coverage may still apply even if the visit is cash.

Peak's cancellation and refund rules

From Peak's Terms and Conditions, effective May 6, 2026:

Topic	What Peak's terms say
Age	You must be at least 18
When you pay	At the time of service, unless arranged otherwise
Changing an appointment	At least 24 hours' notice
Late cancellations and no-shows	A fee may apply; the amount is shown when you book
Refunds	Generally none once services have been given
Packages and memberships	Follow the terms you get when you buy them
Insurance	Not billed directly; cash-pay clinic

The 24-hour rule is about appointments. It isn't a plan for stopping medicine, and stopping treatment is something to talk through with your clinician.

If you move, stop or switch care

Ask these before you start, not after:

• "If I move away, can my care continue, and how do my records get to my next clinician?"
• "Who handles my next refill while I find a new clinician?"
• "If I prepay a package and stop early, what happens to the rest?"
• "How do I raise a concern about my care or a bill?"

If insurance is your priority, Midi says it's in-network with many PPO plans and lets you check your plan. We don't earn anything from Midi.

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Can you use Peak HRT if you don't live in Summit County? {#access}

Ask Peak before ruling it in or out: its current women's pages emphasize local care but do not explain remote visit arrangements. Confirm where the lab draw, consultation and body scan take place, and whether later visits can be by video. Its advertised mobile service is for IV drips in Summit County; that does not establish mobile HRT.

Peak names the towns it serves: Silverthorne, Dillon, Frisco, Breckenridge, Keystone, Vail and the surrounding mountain communities. Peak's general terms set a minimum age of 18; its homepage markets hormone care to men and women 30 and up. Neither is a full eligibility rule, so ask about your situation.

Ask Peak:

• "Where do I need to be for each appointment — labs, the consultation and follow-ups?"
• "Can follow-ups be done by video once I've had my first visit?"

If you're elsewhere in Colorado or in another state, you have three good routes:

1. An online cash-pay service such as Gala (more in the comparison)
2. An insurance-billed online service such as Midi
3. An in-person menopause specialist near you, through The Menopause Society's practitioner directory

Published hours vary across retrieved provider pages. Confirm your appointment time before you drive over the pass.

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Peak HRT vs online menopause care: which fits you? {#compare}

Choose Peak if you live near Silverthorne and want an in-person clinician who starts with broad labs and a body scan. Compare an online service if travel is difficult, you want a published price, or you want to start without a $649 evaluation — Gala for an advertised cash-pay plan, Midi if it accepts your exact insurance, Alloy for products named up front.

This is a fit comparison, not a ranking of medical results.

Peak vs four other routes (prices checked on the dates shown)

	Peak HRT	Gala HRT	Midi Health	Alloy	Your OB-GYN or local menopause specialist
Best for	Summit County women wanting in-person, lab-first care	Cash-pay online care at one advertised monthly price	Insurance and scheduled video visits	Seeing products and prices first	Insured care, complex history
How visits work	In person, Silverthorne	Online clinician review and messaging; video visit in some states	Video visits	Online	In person
Labs before treatment	Included in initial evaluation	Gala says routine hormone testing usually isn't needed; treatment-specific tests may be required	Clinician decides	Alloy says no labs required; it does not order or facilitate them	Clinician decides
Published price	$649 first evaluation; ongoing not published	$69/month advertised, said to include the visit, medicine and shipping	$250 first visit, $150 follow-up (self-pay)	$49 consult; estradiol pills from $39.99/month, generally supplied and billed in three-month blocks	Your quote or plan
Medicine named / FDA status	Not stated	Says FDA-approved forms; product not named; one Gala page mentions compounded medicine	Prescriptions filled at your pharmacy	Published menu	Your pharmacy
Non-hormonal hot-flash option	Not mentioned	Yes, including fezolinetant	Yes	Paroxetine listed	Ask clinician
Insurance	Not billed directly (HSA/FSA)	Not billed (HSA/FSA)	Check exact plan and state	Not billed directly	Depends on clinician and plan
Where	Silverthorne, CO	"Most U.S. states," per Gala	All 50 states, per Midi	Check your state	Near you
Our link	Direct, unpaid	Affiliate	Direct, unpaid	Direct, unpaid	—
Checked	Oct 24, 2026	Oct 24, 2026	Oct 24, 2026	Oct 24, 2026	—

Find yourself

Your situation	Best first step
Live near Silverthorne, want face-to-face care and labs	Peak — book the free call and get prices
Live near Silverthorne, over 45 with classic hot flashes, want the simplest start	Peak's free call to compare prices, or Gala
Prefer remote care, paying cash	Gala — confirm the product, full quote and age/state availability before paying
Have PPO insurance	Midi if your exact plan is accepted, or an in-network clinician
Must have an FDA-approved product named before paying	Alloy, or ask Gala or Peak in writing
Age 35–39 with symptoms that may be perimenopause	Get a clinical assessment before assuming menopause. Peak is a local option to ask about. Online, Winona lists ages 35–59 in supported states; confirm its treatment fits. Gala doesn't publish an HRT age range.
Under 35 with PMOS	An in-person clinician — Peak if local, or gynecology or endocrinology
Unexplained bleeding, cancer, clot or stroke history	A gynecologist or menopause specialist in person first

A 20-second self-check

Answer honestly. Nobody sees this but you.

1. Can I attend the appointments Peak confirms are required?
2. Am I comfortable paying $649 for the evaluation once I have the full quote?
3. Do I want a broad blood panel and body scan, or mainly relief from hot flashes and bad sleep?

Yes, yes, and "I want the labs"? Peak is worth a free call to confirm the fit. No to the first question? Ask about remote arrangements or compare online care. No to the second, or "mainly relief"? An online cash plan or your insurance is likely the simpler start. Still torn? Find My HRT Path can help sort the route.

When Peak is the sensible next step

Peak makes sense if the local, lab-first model is what you want and you're comfortable paying cash once you've seen a full quote. Take the worksheet and the questions below to your free call, and ask Peak to fill in the blanks.

When Gala is the better fit

Gala fits women who want menopause care from home, pay cash or with an HSA or FSA, and would rather not start with Peak's $649 initial evaluation. Gala offers four kinds of treatment, each only with clinician approval:

1. Estradiol pills or patches — estrogen therapy for hot flashes, night sweats and other menopause symptoms
2. Micronized progesterone — protects the uterine lining during estrogen treatment and may improve sleep
3. Vaginal estradiol cream or tablets — for vaginal dryness, painful sex and help preventing recurring UTIs
4. Non-hormonal medicines, including fezolinetant — for hot flashes and night sweats without estrogen, if you can't or prefer not to use hormones

Oral micronized progesterone may improve some sleep measures, but it is not FDA-approved as a sleep treatment. Low-dose vaginal estrogen can help reduce recurrent urinary tract infections (UTIs) after menopause; that use is off-label (The Menopause Society; progesterone labeling). Care is online, with prescriptions delivered and ongoing support. Gala says provider messaging, symptom check-ins and dose changes are included for as long as you're treated, and that prescriptions ship free (Gala, read October 24, 2026). It says hormone blood tests usually aren't needed and are ordered only when they'd change the plan. Its dedicated HRT page advertised $69 a month covering the clinician visit, medicine and shipping when we checked on October 24, 2026.

Why an online-care reader may prefer Gala: it describes online care in most U.S. states, it publishes an advertised monthly price, it lists a non-hormonal option, and it says routine hormone testing usually isn't needed. Any required testing depends on the proposed treatment.

What to confirm before you pay:

• The exact product. Gala's main page says it prescribes FDA-approved bioidentical forms. One of its HRT landing pages carries a notice about compounded medicine. Ask for the product name and maker.
• What $69 covers. Ask whether it includes both estrogen and progesterone if you need both, and who pays if labs are ordered.
• Billing and cancelling. Gala's general policy requires cancellation at least 72 hours before billing and generally does not refund ordinary cancellations. Ask which HRT terms apply, when the first charge occurs, and what is refunded if no prescription is appropriate. One landing page says charging follows approval, while the policy says charging starts when intake is completed.
• Your state and age. Gala says it serves most states and doesn't publish an HRT age range.
• Fezolinetant monitoring. Fezolinetant (Veozah) is FDA-approved and carries a boxed warning about rare but serious liver injury. Its label calls for liver blood tests before starting, monthly for the first three months, and at months six and nine (DailyMed). If it's suggested, ask how those tests are arranged and who pays.

If you'd prefer care from home and Gala confirms your medication, full quote and age/state availability, it offers a way to get a clinician's eyes on your symptoms without Peak's $649 evaluation. Look at the current plan, then check that your checkout screen matches what you've read here.

Featured affiliate option. We may earn a commission. A clinician decides whether any treatment is right for you; a prescription isn't guaranteed. For complaints, cancellation details and the full cost math, read our Gala Health HRT review. Comparing Gala with an insurance route? See Gala vs Midi.

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Where do Peak's own pages disagree? {#conflicts}

A few details don't match across Peak's pages: the size of the lab panel, the length of the first visit and the clinic hours. None is a red flag on its own, but each is worth settling before you book, because the $649 is generally nonrefundable once the service is done.

Topic	One Peak page says	Another Peak page says	What to ask
Lab panel size	"40+ marker" panel (homepage)	"50+ markers" (booking page)	"Which tests are in my $649 panel?"
First visit length	A 30-minute first conversation (homepage process steps)	A 60-minute consultation (homepage service card, booking page)	"How long will I spend with the provider, and is it the same day as my labs?"
Hours	Different hours appear across retrieved provider pages	A seasonal schedule for your appointment was not established	"What are this month's hours, and when is my appointment?"
Ongoing care	"Quarterly check-ins, lab re-tests"	No applicable fee identified in the reviewed pages	"What do follow-ups and repeat labs cost?"
Clinic name in reviews	"Peak HRT"	Some reviews say "Peak TRT"	Context only

All read October 24, 2026.

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What should you ask Peak HRT before you book? {#questions}

Ten questions settle almost everything the reviews can't: the exact medicine, the full monthly cost, visit and lab fees, what happens if hormones aren't recommended, and whether follow-ups can be by video. Peak says you can call or text 970-364-2228, and a text gives you a written record.

Copy these into a text or ask them on the free call:

1. "If you recommend hormone therapy, what exact product, form and strength would I get? Is it FDA-approved or compounded? Do you use pellets?"
2. "What will treatment cost each month after the $649 visit, including medicine?"
3. "What do follow-up visits and repeat labs cost, and how often are they required?"
4. "If you don't recommend hormones for me, what do I end up paying?"
5. "Which tests are in the $649 panel? Will you suggest extra testing, and what would it cost?"
6. "Can my prescription go to my own pharmacy so my drug coverage might apply?"
7. "Can follow-ups be done by video?"
8. "If I have a uterus, how will my uterine lining be protected?"
9. "If I can't take estrogen, what non-hormonal options do you offer?"
10. "What menopause-specific training does the provider have? Is she a Menopause Society Certified Practitioner?"

Already on HRT? Add: "Do you take over existing prescriptions? What records do you need, and do I still need the full $649 evaluation?"

PEAK HRT — MY ANSWERS (private)

Date asked: __________   Asked by: text / call
1. Product, form, strength: ______________  FDA-approved or compounded: ______
2. Monthly cost incl. medicine: $______
3. Follow-up fee: $____ × ____/yr   Repeat labs: $____ × ____/yr
4. If no hormones recommended, I pay: $______
5. Tests included: _______________  Extra testing suggested? ______
6. Can use my pharmacy? ______
7. Video follow-ups? ______
8. Uterine protection plan: _______________
9. Non-hormonal options: _______________
10. Provider's menopause training: _______________

My decision:  book Peak  /  try online care  /  see my own doctor

If you're local and the answers work for you, Peak's free call is the easiest next step. Nothing is charged for it.

We don't earn anything from Peak.

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What health situations change the right choice? {#health}

Your age, how long since your last period, whether you have a uterus, and any history of blood clots, stroke, heart disease, liver disease or hormone-sensitive cancer all change which treatment and which kind of care make sense. Unexplained vaginal bleeding needs evaluation before starting systemic HRT; an in-person examination may be needed.

None of this is advice to start, stop or change a medicine. It's what to bring up so a clinician has the full picture.

Timing matters. The Menopause Society says hormone therapy works best for hot flashes and has the most favorable balance of benefits and risks for healthy women who start it before age 60 or within 10 years of menopause. Outside that window, the decision is more individual. It isn't an automatic no (The Menopause Society).

Some histories can make systemic HRT unsuitable. The Menopause Society lists breast cancer, uterine cancer, unexplained uterine bleeding, liver disease, a history of blood clots and cardiovascular disease as reasons women generally shouldn't use systemic hormone therapy. Low-dose vaginal estrogen has a different risk profile. After hormone-sensitive cancer, that decision belongs with your treating clinician and oncology team. Non-hormonal options exist; see non-hormonal menopause options and fezolinetant for hot flashes.

In-person care is a plus when an examination is needed. A clinic visit allows an examination that an online visit cannot provide. For bleeding or a cancer history, start with the clinician or specialist best placed to evaluate it; an MSCP credential alone does not establish gynecology or oncology expertise.

Testosterone. In the U.S., testosterone is a Schedule III controlled substance and needs a prescription. No testosterone product is FDA-approved for menopause care in women. Using an FDA-approved male product for that purpose is off-label; a compounded product is not FDA-approved (FDA; DEA schedules). Peak lists testosterone therapy for men. Its women's page doesn't mention testosterone, so ask what it offers women and why.

The 2026 label change. On February 12, 2026, the FDA approved labeling changes for an initial group of six menopausal hormone therapy products, removing boxed-warning statements about heart disease, breast cancer and probable dementia (FDA). That doesn't mean hormones are risk-free, every product has the same label, or compounded products became FDA-approved. See the 2026 HRT label changes and HRT benefits and risks.

Mammograms. Some clinics ask for a recent mammogram before HRT. See do you need a mammogram before HRT.

If something in your history gives you pause, a menopause specialist near you is a good first call.

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How did we review Peak HRT? {#method}

We read Peak's public pages, its terms and its review profiles on October 24, 2026, and checked medical points against The Menopause Society and the FDA. We didn't visit, pay or receive care, so this is a documentation review. We don't give Peak a score.

We use The HRT Index Verification Standard, which looks at five things in this order.

Pillar	What we looked for	What we found for Peak	Status
1. Clinical legitimacy	A real business, a named licensed prescriber, a medical review before prescribing	Named company and nurse practitioner; review before treatment stated	Credentials provider-stated; current license not independently confirmed
2. Care quality	Visit time, follow-up, support, complaints	Long visits and quarterly follow-up described; positive accessible excerpts, none explicitly about menopause; no complaint found in the bounded search	Described; review sample is mixed-service
3. Medication fit	Products, FDA-approved or compounded, systemic, local and non-hormonal options	Estrogen and progesterone mentioned; no products, forms or approval status named; no non-hormonal option mentioned	Not confirmed
4. Price transparency	First and ongoing cost, billing and refund terms	$649 first evaluation published; refund and cancellation terms published; ongoing, medicine and repeat-lab prices not	Partial
5. Access	Location, visit type, insurance, age	One clinic in Silverthorne; cash with HSA/FSA; 18+ in general terms; no video hormone care described	Clear for locals; unclear otherwise

What would change our view:

• Peak publishing monthly, medicine and follow-up prices
• Peak naming FDA-approved products, or explaining when it uses compounded ones
• Video follow-ups for women who live farther away
• A body of reviews from women treated for menopause, good or bad
• A menopause-specific credential

What a documentation review can't tell you: how a visit feels, how fast refills arrive or how you'll feel on treatment.

We earn commissions from some providers named here, including Gala and Winona. We earn nothing from Peak, Midi or Alloy, and we include them because a one-sided page wouldn't help you. Our full approach is in our methodology and affiliate disclosure. This page is editorial research and hasn't been reviewed by a clinician (why we label it).

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Quick answers about Peak HRT {#faq}

Is Peak HRT legit? It's a real, named clinic with a named nurse practitioner who, according to Peak, reviews every treatment plan. We could not independently confirm her current license or certification; you can use Colorado's license lookup.

Where is Peak HRT? 358 Blue River Parkway, Suite D, Silverthorne, Colorado 80498.

How much does Peak HRT cost for women? $649 for the first evaluation, which covers labs, a body scan, a consultation and a plan. Monthly treatment costs aren't published, so ask for an itemized quote.

Does Peak HRT take insurance? Peak does not bill insurance directly. It's a cash-pay clinic that accepts HSA and FSA cards for eligible services; separate pharmacy coverage may depend on your prescription and plan.

Does Peak HRT offer telehealth for hormones? Its current women's pages do not establish video hormone care. Ask where each visit must happen and whether follow-ups can be remote. Its advertised mobile service is for IV drips in Summit County.

Does Peak HRT use pellets or testosterone for women? Its pages don't say. Ask before booking.

Is Peak HRT the same as Peak Medical in Park City? No. They're different businesses in different states.

Do I need blood tests before starting HRT? Routine hormone tests usually aren't needed to diagnose menopause at the usual age or choose an HRT dose. Targeted tests can help with early symptoms, suspected PMOS or possible thyroid problems; that is different from requiring a broad panel. See the lab decision table.

Does Peak treat PCOS or PMOS? Yes. Peak lists care for PMOS, the new name for PCOS.

Is there a free consultation? Yes, a free 10-minute discovery call. The $649 evaluation is the first paid step.

What if my estradiol patch is hard to find? In September 2026, the FDA said estradiol patches remain available but specific brands may vary by pharmacy, and that it's working with manufacturers to raise supply after demand rose (FDA update). Ask your prescriber and pharmacy about suitable options; don't switch on your own.

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Bottom line: is Peak HRT right for you?

Peak HRT looks like a well-liked local clinic, and it may fit Summit County women who want an in-person, lab-first start and can pay cash. If you're not nearby, confirm its visit requirements before paying. If insurance or a named medicine is essential, settle that first or choose a route that meets the need.

The whole page in four lines:

• The reviews: a displayed 5.0 Google rating, with positive mixed-service excerpts; the on-site testimonials do not establish menopause-care results.
• The price: $649 for the first evaluation. Complete continuing-care costs weren't available in the reviewed pages, so get a quote.
• The medicine: estrogen and progesterone mentioned; products and FDA status not named.
• The access: a clinic in Silverthorne, Colorado; remote arrangements unconfirmed. Online care is worth comparing if your needs and location fit.

If you're local and ready, Peak's free 10-minute call is the place to start.

Still deciding what kind of care fits? The free Find My HRT Path quiz asks about your symptoms, what you've tried, your age, your state and your health history. Then it shows a featured care option, or tells you when online care isn't the right place to start. It takes about a minute and doesn't need your email.

And if you already have a doctor who knows your history, it's always fair to ask them first.

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Sources

Peak HRT (read October 24, 2026)

• Peak HRT — Home
• Peak HRT — Women's Hormone Therapy
• Peak HRT — Hormone Optimization
• Peak HRT — About Us
• Peak HRT — Book a Service
• Peak HRT — Terms and Conditions, effective May 6, 2026
• Peak HRT — PMOS Care

Reviews and identity checks (read October 24, 2026)

• Birdeye — Peak HRT & IV Drip Lounge
• Peak Medical — Park City, Utah
• Peak TRT & Wellness — Wesley Chapel, Florida
• The Menopause Society — Find a Menopause Practitioner
• The Menopause Society — MSCP Certification

Other care routes (read October 24, 2026)

• Gala — Hormone Health
• Gala — HRT plan page ($69 offer)
• Gala — Other HRT landing page, including compounded-medication notice
• Gala — Progesterone
• Gala — Non-hormonal Options
• Gala — Cancellation and Refund Policy, dated February 2026
• Gala — Terms and Conditions
• Alloy — HRT
• Alloy — Product Menu
• Alloy — Estradiol Pill
• Alloy — Pricing and Billing
• Alloy — Three-month Supplies
• Alloy — What to Expect After Sign-up
• Alloy — Bloodwork and Lab Tests
• Alloy — Terms of Use, revised October 19, 2026
• Midi Health — Pricing and Insurance
• Midi Health — Appointment Costs
• Midi Health — Billing
• Midi Health — HRT
• Midi Health — Perimenopause Care and Availability
• Winona — FAQ

Medical and regulatory (read October 24, 2026)

• The Menopause Society — Hormone Therapy
• The Menopause Society — 2022 Hormone Therapy Position Statement
• Australasian Menopause Society — Diagnosing Menopause
• ASRM — International Guideline for PMOS/PCOS Assessment and Management
• FDA — Compounding and the FDA: Questions and Answers
• FDA — Labeling Changes for Menopausal Hormone Therapy Products, February 12, 2026
• FDA — Update on Estradiol Transdermal Patch Availability, September 3, 2026
• DailyMed — Veozah (fezolinetant) Prescribing Information, label updated February 26, 2026
• DailyMed — Prometrium (progesterone) Prescribing Information, label updated July 23, 2026
• FDA — Testosterone Information
• DEA — Controlled Substance Schedules
• Global Name Change Consortium — PMOS Consensus Paper: Author Abstract and Publication Record, The Lancet, DOI 10.1016/S0140-6736(26)00717-8; online May 12, 2026
• Endocrine Society — PMOS Name Change and Implementation, May 2026

The HRT Index is an independent editorial publication. We are not a healthcare provider, pharmacy or telehealth service. Nothing here is medical advice, a diagnosis or a treatment plan. For decisions about starting, stopping or changing hormone therapy, talk with a licensed clinician who knows your history. In an emergency, call 911.

Keep reading:

• Compare online HRT providers for menopause
• HRT cost in 2026 by care model
• Local treatment for vaginal symptoms
• Another in-person clinic review: Aspire Rejuvenation
• Perimenopause symptoms checklist to bring to any first visit

MY HRT COST CHECK (keep this private)

Clinic or provider: ____________________   Date asked: __________
Start date: __________
First 90 days: start date through the day before start + 90 days
First year: start date through the day before its 12-month anniversary

Amount charged today: $______   What it covers: __________________
First visit / evaluation: $______   Charge date: __________
Medicine charge: $______ every ______   First / next charge dates: __________
Follow-up fee: $______   Number in first 90 days: ____   In first year: ____
Repeat-lab fee: $______  Number in first 90 days: ____   In first year: ____
Membership / package: $______ every ______   Minimum commitment: ______
Shipping / other required charges and dates: ______________________
Included in a price above (do not count twice): ___________________
If no prescription is right: I pay $______   Refund terms: __________

FIRST 90 DAYS = every required charge actually due in that window
FIRST YEAR = every required charge actually due in the stated year
Count included services once. List optional items separately.

For each item, mark: quoted / included / not required / unknown.
A required amount, date or count is unknown? My total is INCOMPLETE.
Do not turn a blank into $0, or annual visit counts into 90-day counts.

PEAK HRT — MY ANSWERS (private)

Date asked: __________   Asked by: text / call
1. Product, form, strength: ______________  FDA-approved or compounded: ______
2. Monthly cost incl. medicine: $______
3. Follow-up fee: $____ × ____/yr   Repeat labs: $____ × ____/yr
4. If no hormones recommended, I pay: $______
5. Tests included: _______________  Extra testing suggested? ______
6. Can use my pharmacy? ______
7. Video follow-ups? ______
8. Uterine protection plan: _______________
9. Non-hormonal options: _______________
10. Provider's menopause training: _______________

My decision:  book Peak  /  try online care  /  see my own doctor