If you have received a consultation for gynecological concerns and you would like to recommend your practioner, fill out the questionnaire below! This form is anonymous and it will not be shared. It will only take 4-5 minutes of your time to complete the form.
- If you want to submit the names of multiple practitioners, you must submit a questionnaire for each of them.
- No practitioner is perfect. Even if they don't meet all the criteria, send us the completed questionnaire anyway.
- If you are a practitioner (general medicine or gynecology) we ask that you please don't submit yourself. This project is made FOR and BY our users.
- All questions marked with an asterisk (*) are required.
Remember, this is an evolving, collaborative project which depends on all of you! We are counting on you to add to it, complete it and keep it up to date via comments or e-mails (your communications will be considered but will not be published).
And don't hesitate to e-mail us at email@example.com! We want to hear any questions you have about practitioners, your personal requests, or if you want to get involved.
P.S. Any practitioner who does not want their name to appear on our site should let us know by e-mail: firstname.lastname@example.org. The information will be removed.