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Age

How did you hear about us?

1) Are you under the age of 35 and trying to conceive for at least 1 year?

2) Are you over the age of 35 and trying to conceive for at least 6 months?

3) Are you menstrual cycles irregular or have heavy bleeding?

4) Do you have severe pain with your menstrual cycles?

5) Do you have pain with intercourse?

6) Have you ahd any types of abdominal surgeies, cervical procedures (LEEP) or previous pregnancies?

7) Have you had more than one miscarriage?

8) Have you had any type of fertility testing, such has a Hysterosalpingogram or semen analysis?

9) Has you husband/partner fathered any children?

10) Have you or your husband/partner been exposed to chemicals or radiation?

11) Have you been timing intercourse appropriately?

12) Are you frustrated and wanting to give up?

Questions or Comments?