Question Title

* Do you provide routine health care to women?

  Yes No
Adolescent?
Adult?
Menopausal?
Pregnant?

Question Title

* Please answer yes or no.

  Yes No
Do you provide routine prenatal care?
Do you provide high-risk prenatal care?
Do you perform in-office or bedside ultrasonography?
Do you assist in deliveries?
Do you screen and/or treat female patients for sexually transmitted infections?
Do you insert or remove intrauterine devices?
Do you perform in-office contraceptive procedures (implanon, essure)?
Do you perform diaphragm insertion?
Do you perform colposcopies?
Do you perform LEEPS?
Do you insert pessary devices?
Do you perform endometrial biopsies?
Do you perform vulvar biopsies?
Do you perform breast exams?
Do you evaluate and/or manage ovarian cysts?
Do you evaluate and/or treat uterine fibroids?
Do you assist in gynecologic surgery?
Do you round on hospital or OB/GYN patients?
Do you provide surgical or medical abortion services?

Question Title

* For your female patients do you prescribe:

  Yes No
Contraceptive pills?
Contraceptive patches/rings?
Contraceptive injections?
Oral hormone therapy for menopause?
Vaginal creams for menopause?
SSRIs or other medications for depression and/or anxiety?
Thyroid medications?
Osteoporosis medications?
Sleep medications?
Incontinence medications?
Reproductive assistance medications?
Antibiotics for sexually transmitted infections?
Antiviral medications for genital herpes?
Treatments for genital warts?
Medications for vaginitis?
Medications for female sexual dysfunction?

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