Your Feedback: Women’s Health

1. Are you a Stillwater Medical Group patient?*   Yes No       2. Which type of providers do you see (check all that apply)?*   OB/GYN   Family Medicine   Internal Medicine   Certified Nurse Midwife   Physician Assistant   Nurse Practitioner   Other (please list)               3. What is your age?*   0-17   18-39   40-54   55-64   65+         Preventive Health       4. Which preventive health measures have you taken (check all that apply)?   Osteoporosis Screening   Osteoporosis Education   Osteoporosis Follow-Up   Annual Health Risk Assessment Visits         Diagnosis and Treatment       5. Which treatments have you participated in (check all that apply)?   Incontinence Management (leaking urine)   Menopause Management   Infertility Care   Individual Counseling   Family Counseling   Group Counseling         Integrative Medicine       6. Which integrative medicine treatments and services have you participated in (check all that apply)?   Acupuncture Treatments   Massage Therapy   Nutritionist Services   Weight Management   Reflexology   New Moms Assistance with Lactation   Healing Touch   Guided Imagery   Relaxation Therapy   Meditation   Hypnosis   Chiropractic Therapy   Chronic Pain Management         Fitness       7. Which fitness classes have you participated in or currently take (check all that apply)?   Yoga Classes   Pilates Classes   Prenatal Classes         Education       8. Which educational classes have you participated in or currently take (check all that apply)?   Health Education Classes   Financial Planning Classes   Healthy Cooking Classes         Support Groups       9. Which support groups have you engaged in or do you currently participate in (check all that apply)?   Heart Health   Breast Health   Menopause Symptoms   Infertility         Center for Women's Health       10. What sort of information, services and treatments would you like to receive at the Women's Center (check all that apply)?*   Osteoporosis Screening   Osteoporosis Education   Osteoporosis Follow-Up   Annual Health Risk Assessment Visits   Incontinence Management (leaking urine)   Menopause Management   Infertility Care   Individual Counseling   Family Counseling   Group Counseling   Acupuncture Treatments   Massage Therapy   Nutritionist Services   Weight Management   Reflexology   New Moms Assistance with Lactation   Healing Touch   Guided Imagery   Relaxation Therapy   Meditation   Hypnosis   Chiropractic Therapy   Chronic Pain Management   Yoga Classes   Pilates Classes   Prenatal Classes   Health Education Classes   Financial Planning Classes   Healthy Cooking Classes   Heart Health Support Group   Breast Health Support Group   Menopause Symptoms Support Group   Infertility Support Group   Other, please specify               11. Please let us know about the care you recieved at Stillwater Medical Group's Center for Women's Health.           Thank you for participating in this women's health forum. With your help and the partnership of other St. Croix Valley women, we will continue to build the Women's Center at Stillwater Medical Group with services that fit your needs.