10 questions to ask a telehealth TRT clinic before you pay
To choose a safe, legitimate online testosterone clinic, confirm that a prescriber licensed in your state reviews two early morning testosterone tests before prescribing, monitors your hematocrit and PSA on a schedule, talks with you about fertility, and tells you exactly which pharmacy makes your medication. A legitimate telehealth TRT clinic will answer all 10 questions below clearly, ideally in writing, before you pay anything. If a clinic dodges them, keep looking.
This checklist works for any provider: a national HRT online clinic, a local practice in New Jersey or California, or BioCure Health. It is built on the Endocrine Society's 2018 testosterone therapy guideline (Bhasin et al., Journal of Clinical Endocrinology and Metabolism) and the FDA's testosterone information page. A good clinic should be able to discuss both comfortably.
The 10 questions at a glance
Use this table as your script on the first call.
| # | Question to ask | A good answer | Red flag |
|---|---|---|---|
| 1 | Is the prescriber licensed in my state? | A named clinician whose license you can look up | "Our provider network" with no names |
| 2 | Do you require two morning labs before prescribing? | Yes, two early morning tests on separate days | A prescription after one test or a symptom quiz |
| 3 | What do you test at baseline and after? | A defined panel plus follow-up at 3 to 6 months and 12 months | Labs are "optional" |
| 4 | FDA-approved or compounded, and from which pharmacy type? | The exact product, plus the pharmacy's name and type | "Pharmaceutical grade" with no details |
| 5 | What happens if hematocrit or PSA rises? | Written thresholds and a plan | "That almost never happens" |
| 6 | Do you address fertility first? | Asked before the first prescription | Never comes up |
| 7 | Can I be seen in person? | A clinic location or referral path | No fallback at all |
| 8 | What does the monthly fee include? | An itemized list | Surprise lab, shipping or consult charges |
| 9 | How do I cancel or taper off? | A clear policy and a medical plan for stopping | Auto-renewal with no exit guidance |
| 10 | Who answers when I have a side effect? | A clinician, with a stated response time | Only a sales rep or a chatbot |
Question 1: Is the prescriber licensed in your state?
In telehealth, the law follows you. Your prescriber generally must hold an active license in the state where you are physically located during the visit, not the state where the company is headquartered. Testosterone is also a Schedule III controlled substance, so the prescriber needs a DEA registration. Federal rules for prescribing controlled substances by telemedicine have been in flux in recent years and may change again, so ask how the clinic will keep your care going if those rules change.
How to check in five minutes:
- Ask for the full name and credentials of the clinician who will actually write your prescription.
- Search that name on your state medical board's license lookup. Confirm the license is active and check for disciplinary actions.
- In New Jersey, the Board of Medical Examiners also posts public alerts and notices worth scanning. In California, use the Medical Board of California's online license search. The Federation of State Medical Boards' DocInfo tool searches across states.
- Ask whether the prescriber is a physician, nurse practitioner or physician assistant, and what their board certification is. All three can prescribe legitimately in many states. What matters is that you know who is responsible for your care and how they are supervised.
Questions 2 and 3: Which labs come before and after the prescription?
The Endocrine Society guideline recommends diagnosing low testosterone only in men who have symptoms and consistently low levels, measured with a fasting early morning total testosterone test and confirmed with a repeat test. Testosterone peaks in the morning and varies from day to day. A bad night of sleep, an illness or a hard training block can push one result low. A clinic that prescribes from a single afternoon test is skipping the step that separates a real diagnosis from a bad day.
A thorough clinic also asks why your level is low. LH and FSH help show whether the problem starts in the testicles or in the pituitary signals that drive them, and that distinction can change the treatment plan.
| Test | Baseline | After starting | Why it matters |
|---|---|---|---|
| Total testosterone (morning, fasting) | Two separate tests | 3 to 6 months, then periodically | Confirms the diagnosis and guides dosing toward the mid normal range |
| Free testosterone | When total is borderline or SHBG may be altered | As needed | Clarifies unclear results |
| LH and FSH | Yes | Not usually | Identifies the cause |
| Hematocrit (CBC) | Yes | 3 to 6 months, 12 months, then yearly | Testosterone can thicken the blood |
| PSA | Men 55 to 69, or 40 to 69 at higher risk, who choose monitoring | 3 to 12 months, then per screening guidelines | Prostate safety |
| Estradiol, lipids, metabolic panel | Common clinic practice | Varies | Ask how results change your plan |
Ask to see the clinic's schedule. If follow-up labs are "recommended" but not built in or included, that is a gap. You can see how BioCure structures testing on our diagnostics page.
Question 4: Is the medication FDA-approved or compounded?
Several testosterone products are FDA-approved, including generic testosterone cypionate injection. FDA approved testosterone for men with low testosterone caused by specific medical conditions, and it has stated that the benefit and safety of treating low testosterone due to aging alone have not been established. Its testosterone information page summarizes the safety communications and label changes behind that position.
Compounded testosterone is a different category. Compounded drugs are not FDA-approved, and their quality depends heavily on who makes them.
| Source | Who oversees it | What to ask |
|---|---|---|
| FDA-approved product | FDA reviews safety, effectiveness and manufacturing | Which brand or generic, and why this form? |
| 503A compounding pharmacy | Mainly the state board of pharmacy; compounds for individual prescriptions | Pharmacy name, state license, and potency and sterility testing |
| 503B outsourcing facility | Registered with FDA, held to current good manufacturing practice, subject to FDA inspection | Facility name and recent inspection history |
One wording trap: there is no such thing as an "FDA-approved pharmacy." A 503B facility is FDA-registered. Ask the clinic to name the pharmacy so you can look it up yourself.
Questions 5 and 6: What about hematocrit, PSA and fertility?
Hematocrit. Testosterone stimulates red blood cell production. The Endocrine Society recommends against starting therapy when hematocrit is above 50% without evaluating the cause. If it rises above 54% during treatment, the guideline advises stopping until it comes down, looking for causes such as sleep apnea, then restarting at a lower dose. Ask for the clinic's exact threshold and what it does next: lower the dose, change the form, pause treatment or refer you.
PSA. The guideline calls for urologic evaluation if PSA rises more than 1.4 ng/mL within 12 months, if a confirmed PSA is above 4.0 ng/mL, or if a prostate exam is abnormal. A clinic should tell you who handles that referral and how quickly.
Fertility. Prescribed testosterone tells your brain to stop sending LH and FSH, the signals your testicles need to make sperm. Sperm counts can fall very low or to zero. The guideline recommends against testosterone therapy in men planning to have children in the near term. A responsible clinic asks about your family plans before the first prescription, not after, and discusses alternatives or referral to a urologist or reproductive specialist.
Questions 7 to 10: In-person care, fees, stopping and side effects
Can I be seen in person? Telehealth handles most follow-up well. Some things still need hands: a testicular or prostate exam, a blood pressure check, a closer look at a new symptom. Ask whether the clinic has a physical location or a referral path.
What does the monthly fee include? Get it itemized before you enter a card number. Confirm whether the price covers physician visits, baseline labs, follow-up labs, medication, syringes and supplies, shipping, and messaging. Ask what happens to the price if your dose changes. At BioCure, membership pricing depends on your protocol and is reviewed at your consultation. The $199 physician consultation can be credited back with a membership, and ongoing follow-up and support are included. See our testosterone therapy page for the treatment tiers.
How do I cancel or taper off? Ask two separate questions. The business one: is there a contract, does it auto-renew, and are shipped medications refundable? The medical one: what is the plan if you want to stop? After testosterone is stopped, your body has to restart its own production, which can take weeks to months, and low testosterone symptoms can return in the meantime. Some clinicians use medications to support recovery; whether that fits you is an individual decision.
Who answers when I have a side effect? Acne, fluid retention, breast tenderness, mood changes and worsening sleep apnea are known possibilities. Ask who responds (a clinician or a support agent), how fast, and what happens after hours. Chest pain, shortness of breath, leg swelling, sudden weakness or trouble speaking need emergency care, not a portal message. Call 911.
How BioCure Health answers these questions
We publish this checklist because we expect to be held to it. BioCure Health is a physician-led telehealth clinic with a physical clinic in the Fort Lauderdale area, licensed to treat patients in 47 states, and availability in your state is confirmed at intake. Care is led by our physicians, and every protocol is lab-driven, starting with comprehensive baseline diagnostics and a 1:1 review of your results, with ongoing monitoring as your protocol requires. Compounded medications come from licensed compounding pharmacy partners and ship to your door. Ongoing follow-up and support are included, and any appointment can be done in person at our clinic when a hands-on exam is the right call.
Where we fit best: you want a physician who knows your labs, a direct line when something feels off, and the option to walk into a clinic. If your top priority is the lowest possible monthly price or insurance billing, compare those details directly, and ask us the same 10 questions you ask everyone else.
Frequently asked questions
How do I know if an online TRT clinic is legit?
A legitimate clinic names the prescriber, who holds an active license in your state that you can verify on the state medical board website. It requires two morning testosterone tests before prescribing, schedules follow-up labs, and tells you which pharmacy makes your medication. Vague answers on any of these are a reason to walk away.
Is it legal to get testosterone prescribed through telehealth?
Yes, when the prescriber is licensed in the state where you are located and holds a DEA registration, because testosterone is a Schedule III controlled substance. Federal telemedicine rules for controlled substances have changed in recent years, so ask the clinic how it complies today.
Do I need blood work before starting TRT online?
Yes. The Endocrine Society recommends confirming low testosterone with repeat fasting early morning tests in men who also have symptoms. Good clinics also check hematocrit, LH and FSH, and PSA when age appropriate, before writing a prescription.
Is compounded testosterone safe?
Compounded testosterone is not FDA-approved, so its quality depends on the pharmacy that makes it. 503B outsourcing facilities are FDA-registered and follow manufacturing standards, while 503A pharmacies are mainly overseen by state boards. Ask your clinic to name the pharmacy so you can check it yourself.
Will TRT affect my fertility?
It can. Testosterone therapy suppresses the hormones your testicles need to make sperm, and sperm counts can drop to zero. The Endocrine Society recommends against TRT for men planning to have children soon, so raise this before you start.
What happens if I stop testosterone therapy?
Your body has to restart its own testosterone production, which can take weeks to months, and low testosterone symptoms may return during that time. Ask the clinic about its plan for stopping before you begin, so you are never left without guidance.
Testosterone therapy is a long-term medical decision, and the clinic's process matters more than its marketing. Ask the 10 questions, write down the answers, and choose the clinic that responds like a physician rather than a salesperson. When you are ready, you can contact us and put us through the same test.
Let BioCure Health lead you in the right direction. Call or text us to schedule an introductory call at 754-206-0838. Your future self will thank you.