Current First page Second page Third page Fourth page Fifth pageIt can be difficult to know what to bring with you to your health appointment so let us help you. Fill in the questions below and you will be able to download a report that you can take with you to your health appointment. The more information that you can provide, the better you will be able to advocate for your own health plan.Bonus!You asked, and we provided! At the end you can choose to save your details and compare them over time.Login to see your saved reportsFirst, get a quick symptom check Date of birth Date of birth: DayDay12345678910111213141516171819202122232425262728293031 Date of birth: MonthMonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Date of birth: YearYear202520242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930 Your postcodeOver the last 6 months have you: had regular, severe period pain No Yes had significant interference to your usual daily activities because of your period No Yes experienced bowel or bladder pain No Yes regularly missed school or work because of your period? No Yes felt sure there is something wrong with your periods? No Yes© MDOT/PIPPA Study Parker, Kent, Sneddon, Wang, Shadbolt JPAG 2021; Parker, Sneddon, Arbon BJOG 2010No part of this publication may be copied, recorded or otherwise reproduced either electronically or manually, stored in a retrieval system or transmitted by any means without the prior permission of Canberra Health Services.Have an appointment with your doctor soon?Create a report for my doctor
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