The State of Womxn's Health: We Need Your Voice!
If you're a womxn or non-binary person, your voice matters on the present and future of womxn's health.

Please share your answers in this quick 5-minute survey. Thank you!
Sign in to Google to save your progress. Learn more
What is your age range?
Clear selection
How often do you go to the OB/GYN for a wellness check-up?
Clear selection
If you have not visited the OB/GYN in the past year, why not?
Which of the following have you used before? (choose all the apply)
Which of the following would you consider using? (choose all the apply)
 When it comes to your pelvic exams (well-woman gynecological exams), how do you feel? (choose all that apply)
What about the OB/GYN do you dislike? (check all that apply)
In which area do you see a great need for your own personal education? (choose all that apply)
On a scale from 1-5, what would your comfort level be with a house call from a licensed medical professional in your own home?
very uncomfortable
very comfortable
Clear selection
On a scale from 1-5, what would your comfort level be with entering hospitals and private practices amidst the current pandemic?
very uncomfortable
very comfortable
Clear selection
If a licensed professional in women's health could show up to your home in Personal Protective Equipment (PPE), ready to perform your annual exam, would you consider engaging their services?
Clear selection
Please share your EMAIL below to learn the latest about our innovations in womxn's health. We promise not to spam or contact you often!
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms