Women’s Health Consult – Every Mother Matters Healthcare

Please provide answers to the questionnaire below. Our team of experts is committed to helping you reach your goals. NB! If you already know your diagnosis simply visit the PRESCRIPTION GUIDE PAGE to order the treatment package suitable for your medical challenge.

Name *

First

Last

Email *

Age

Marital Status

Mobile Number *

State

City

Country

How long have you been trying to conceive

Is your cycle regular?

Is the flow scanty, normal, or heavy?

What’s the date of your last period and cycle length?

Do you experience vaginal infection?

Do you experience sperm leakage after intercourse?

Has your hubby done semen analysis?

Do you experience breast discharge?

What are other symptoms you observe?

When was the last time you treated infection?

Have you done any surgery in the past? Indicate the type and year.

Have you conducted culture test, hormone profile test and or pelvic ultrasound scan recently? Please snap and send report(s) for review

and your discharge?

When was the scan done and what’s the size(s) of the fibroid or cyst in mm/cm?

Do you have any other complaints? Comment here

Upload Lab report to Google Drive and drop the link here.

Please type RESTORED below