Cycle consulting

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First name *

Last name *

Postal code *

Has your account been authorised for OvulaRing service?

The following personal details are relevant for the assessment of your cycle and serve to improve the statements of the cycle counselling. The information is voluntary and is collected exclusively for the purpose of processing the cycle counselling. You can revoke this information at any time under info@ovularing.com.

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Email address *

OvulaRing customer number *

I am using OvulaRing ... *

Do you live in a same-sex partnership?

The following personal details are relevant for the assessment of your cycle and serve to improve the cycle consulting accuracy. The details are voluntary and are collected exclusively for the process of cycle consulting. You may withdraw these details at any time at info@ovularing.com.

Year of birth

Height

Weight

Do you already have children of your own?

We will now ask you a number of questions about your health. We will treat these data confidentially. Our data protection declaration can be found at Privacy Policy.

Have you used hormonal birth control?

How long did you use the hormonal contraceptive?

When did you stop using hormonal contraceptives?

How regular are your menstrual cycles?

How often do you have your period?

How long have you been trying to get pregnant?

Do you have any underlying illnesses?

What underlying illnesses do you have?

Do you take medication regularly?

What medication do you take regularly?

How familiar are you with fertility awareness methods?

Have you already used methods for conception optimization?

Have you already used natural contraception methods yourself?

Have you already used methods for cycle observation yourself?

Which methods for conception optimization have you already used?

Which methods of natural contraception have you already used?

Which methods of cycle observation have you already used?

What other method did you use?

Were you or are you already in gynaecological care regarding your desire to have children?

Have you been diagnosed with a hormonal cycle disorder?

What exactly was diagnosed?

Are you currently taking medication to get pregnant?

What medication are you currently taking to get pregnant?

Have you ever undergone reproductive medicine treatment?

What reproductive medicine treatment have you undergone?

Has your partner been examined?

What was discovered with your partner?

What is your occupation?

Do you work shifts?

To what extent do you feel psychologically stressed or stressed at work or privately?

Do you exercise regularly? If yes, how often per week?

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I have read and agree with the data protection declaration.

I consent to VivoSensMedical processing the data that I have entered in this form for the answering of my enquiry. This consent may be withdrawn at any time at info@ovularing.com.

Free cycle consultation for OvulaRing customers

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