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): * Intrauterine device (IUD) Implant Vaginal ring A and B A, B, and C B and C 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? * None Less than 25% 26% - 50% 51% - 75% More than 75% Don’t know 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 If you are interested in participating in the raffle for a $100 Amazon gift card, please fill out the following: First Name Last Name Email Address Leave this field blank
