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Get OB & GYN New Patient Information 2008-2024

Ular monthly periods? Y / N How often do your periods come? Periods are: Mild Moderate Age at first period Heavy Cramps are: Mild Moderate Severe Drug Allergies: Current birth control: Age at first intercourse: Number of partners (lifetime): Are you having any libido changes? Y / N (please explain) Do you have pain with intercourse? Y / N (please explain) Sexual Preference: (please circ le) Heterosexual Homosexual Bisexual Have you had a new sexual partner since last exam? Y / N.

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