Questionnaires

This questionnaire helps to establish what impact fibroid have on your quality of life . I use to establish and define a specific problem. It allows us to what impact it has on your quality of life and a good measuring stick to compare treatments before and after therapy. Please complete the related Questionnaire prior to your arrival to save time and help to diagnose you faster and more reliably.

Complete this form if you are coming to see me for heavy menstrual bleeding

Complete this questionaire if you are concerned about having low sex drive, lack of sex drive, low libido, etc

Complete this form if you are coming to see me about having panic attacks, anxiety which include symptoms of chest pain, anxiousness or nervousness, feeling of doom, sweaty, clammy, fast or irregular heartbeats.

Complete this questionaire if you are coming to see me with PMS like symptoms but a more severe form (adversely affecting your relationships at home or work)

Complete this questionaire if you are coming to see me regarding concerns of pelvic organ prolapse, something falling out of your vagina

Complete this questionaire if you are coming to see me regarding symptoms of PMS or pre-menstrual syndrome including mood alteration, sleep disturbances, GI upset, impaired cognition in the days before start of your menstrual cycle.