Tell Us About Your AUB Symptoms

Do you have to change your pads or tampons more frequently than every 2-3 hours?*

Do you pass clots?*

Do your periods last longer than 5-7 days from start to finish?*

Have your periods become progressively longer or heavier over the years?*

Do you risk soiling or leakage if you can't change sanitary products in time?*

Do you find yourself limiting your activities during the time of your flow due to its heaviness or pain?*

Do you feel drained during your period or have you been told that you are anemic?*

Tell Us About Yourself

Name*

First Last

Phone Number*

Email Address*

I would like to receive a call to schedule a consultation with Dr Jones:*