How would you describe the amount of your periods?
What is the colour of your period?
Do you have blood clots during your period?
Do you have white discharge between periods?
If yes, what is the nature?
Do you experience cramping with your periods?
If yes, when during your cycles do you have pain (check all that apply)
How would you describe the cramps?
Do you have other symptoms with your periods?
If yes, when during your cycles do you have these symptoms (check all that apply)
Do you bleed or spot between periods?
Have you ever had any of the following infections involving any part of the reproductive system?
Have you ever used contraception in the past?
Have you been treated for infertility previously?
Have you ever attempted in vitro fertilization (IVF)?
Have you had a miscarriage before ?
Do you have or have you ever had any of the following:
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