To help us understand that this treatment is the right option for you, please answer the following questions. If you get stuck or need any help, you can contact us.

0%




At least 72 hours
A week
A month
More than a month


Male
Female
Transmale (Born a female)
Transfemale (Born a male)

Presently Pregnant
Presently Breastfeeding
Planning on getting pregnant
Neither Pregnant nor Breastfeeding