Feedback Survey

Question Title

* 1. What is your age?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

Question Title

* 2. What are topics you are interested in learning more about?

Pregnancy - Anatomical and physiological changes by trimester

Pregnancy - Hormone changes

Pregnancy - Sleeping positions

Carpal tunnel

Positional dizziness (vertigo)

Pelvic pain/pain with sex

Pelvic organ prolapse

Urinary incontinence (leaking)

Urinary urgency/overactive bladder

Fecal incontinence

Constipation

Hemorrhoids

Cesarean section recovery

SI dysfunction

Sciatica

Low back pain

Neck pain

Return to activity after childbirth (i.e. running, jumping, strength training)

Activities you can do before 6 week OB visit

Pelvic floor anatomy

Diastasis recti

Other (please specify)

Question Title

* 3. If you are/have been pregnant, what are issues you have encountered during pregnancy?

Neck/upper back pain

Low back back

SI dysfunction

Sciatica

Calf cramps

Carpal tunnel

Dizziness

Round ligament pain

Incontinence/leaking

Pelvic pain/pain with sex

Hip pain

Pubic symphysis dysfunction/pain

Pelvic pressure

Difficulty with positioning for sleep

Hemorrhoids

Constipation

Varicose veins

Other (please specify)

None of the above/Not applicable

Question Title

* 4. If you have given birth, what birth experiences have you had? (Select all that apply)

Vaginal

Cesarean

VBAC

Not applicable

Question Title

* 5. If you have given birth, what are issues you encountered postpartum?

Urinary incontinence

Fecal incontinence

Pelvic organ prolapse

Granulation tissue

Vaginal tearing

C-section scar pain

Inability to return to activity

Diastasis recti

Pain with sex

Hemorrhoids

Clogged milk ducts

Mastitis

Overactive bladder

Other (please specify)

None of the above/Not applicable