Long-acting reversible contraception Survey

Which of following is your specialty? *

OBGYN

PCP (GP, FP, NP, PA, DO)

Pediatrics or adolescent medicine

Other...

Which of following is your specialty? Other...

How many sexually active female patients aged between 12 and 60 years do you see per month (on average): *

Less than 10

10 - 30

31 - 50

More than 50

Do you initiate discussions about contraception with your sexually active female patients aged between 12 and 60 years? *

Yes

No

I don’t initiate discussions, but do answer my patients’ questions if they initiate the discussion.

Which of the following is a long-acting reversible contraceptive (LARC): *

Please rate your degree of familiarity with currently available LARCs: *

Not at all familiar

Somewhat familiar

Very familiar

Extremely familiar

Of your sexually active patients aged between 12 and 60 years, how many are using LARCs? *

Which of following patient group(s) is/are a good candidate for a LARC? *

Sexually active adolescent (10 – 19 years)

Young adult unmarried (20 – 35 years)

Young adult married (20 – 35 years)

Adult woman >20 years

Any of the above

None of the above

Please rate your degree of confidence in educating your sexually active female patients about LARCs? *

Not at all confident

Somewhat confident

Very confident

Extremely confident

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First Name

Last Name

Email Address

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