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Hormonal Contraceptive SelfScreening Questionnaire Name Health Care Providers Name Date Date of Birth Age* Weight Do you have health insurance? Yes / No What was the date of your last womens health.

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The nurse or doctor may ask about your sex life: whether you've ever had sex, what kinds of sex, how many people you've had sex with, if you've used birth control before, etc. It's super important to be honest so they can give you the best possible care.

How do I choose? Your age and health history. Your reproductive goals, such as the number of children you want and how soon you want to get pregnant. Relationship factors, including marital status, number of sexual partners, how often you have sex and partner preferences. Religious beliefs.

Your health care provider will want to talk with you about your medical history and check your blood pressure. You might also need a pelvic exam. Your health care provider may also want to know about your sex life and sexual history: how many partners you've had, what kind of birth control you currently use, etc.

10 Questions to Ask Your Doctor About Birth Control What are the different methods for birth control? ... How effective is the birth control? ... How reversible is the birth control method? ... How costly is the birth control method? ... Is it convenient? ... Does the birth control fit my health profile and family history?

Here are the top questions to ask yourself when making this decision. How Important Is Ease of Use and Convenience? ... How Comfortable Would You Be Using a Particular Birth Control Method? ... Will the Contraceptive Prevent Sexually Transmitted Diseases? ... Do You Want to Have a Biological Child in the Future?

1 Do you think you might be pregnany now? 2 What was the first day of your last mentrual period? 3 Have you ever taken birth control pills, or used a birth control patch, ring, or shot/injection? Did you ever experience a bad reaction to using hormonal birth control? - If yes, what kind of reaction occurred?

The Contraceptive Intent Questionnaire (CIQ) measures the latent construct of contraceptive intent and is designed to capture both conscious and unconscious factors that comprise a woman's predisposition to use contraception.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232