Choose the Options That Best Describes You
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I've been trying to get pregnant for less than 6 months
I've been trying to get pregnant for 6 months or more
I'm trying to grow my family, but will need a donor or surrogate
I'm not trying to get pregnant currently, I'm interested in preserving my fertility
Choose the Options That Best Describes You
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I have painful periods and I don't know why
I experience pain during intercourse and I don't know why
I have been diagnosed with endometriosis
I have been diagnosed with polycystic ovary syndrom (PCOS)
I have other pelvic pain and I don't know why
My partner and I aren't ready to have a baby yet, but want to make sure we can have one when the time comes
I don't have a partner right now, but I want to make sure I can have a child in the future
I am/will be undergoing cancer treatments and I'm worried I won't be able to have children in the future
Age
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I'm under 35
I'm over 35
Children
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I don't have any biological children
I have at least one biological child
Status
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I am part of a heretosexual couple
My partner and I are both women
My partner and I are both men
I am a single man
I am a single woman
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Name
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First Name
Last Name
Email
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Phone Number
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Format: (000) 000-0000.
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