Thank you for filling the questionnaire.

Many women suffer, often in silence, with their menstrual cycle. They take medication, hormones or go through medical procedures. Wouldn’t it be wonderful if many women knew about an option that is drugfree and non-invasive?

I need your help!

The more data we can collect on the effectiveness of the Carefree Periods Apphirmations, the easier it will be to bring hope to other women. Please fill in this questionnaire before you start using the Carefree Periods Apphirmations. Then you can fill it in monthly or after each period.

I really value your input!Please answer all the questions. If it is not applicable to you, just write N/A

My Promise to YOU!

Your data will only be used for research purposes. The data will only be presented publicly anonymously.

Because you will be filling in the questionnaire a few times, we will use your name to identify you and link your submissions to each other.

Four out of ten women struggle with their monthly cycle. We are using your data, to build a strong case that there is an alternative solution available for them.

Carefree Periods Questionnaire

"*" indicates required fields

Date*

email address*

Name and age of person with mensturation issues*

First

When was your last menstruation?*

1. How many days do you bleed heavily?*

2. How many days do you experience excessive pain?*

3. How many days do you take pain medication?*

4. How many days do you feel bloated / uncomfortable?*

5. How many days are you absent and/or are less productive?*

6. Do you feel insecure that time of the month?*

7. Do you plan your activities around your periods?*

8. Are you emotional, irrational and/or fight with others that time of the month?*

9. How much are your periods negatively impacting your quality of life?*

10. Have you been diagnosed with endometriosis? If yes, what stage?*

11. Have you been diagnosed with ovarian cysts? If yes, what is the current size of the biggest one?*

A. How many years have you been struggling with your periods?

B. How many days have you used the Carefree Periods Apphirmations*

C: Have you noticed other changes in your life in general, since using the App?

This question can only be answered after you have used the Apphirmations. I am asking about changes you have noticed that are not linked to your menstruation. E.g. maybe you have more energy, you have a more positive outlook on life, the strenght of other medications changed, etc.

Phone

This field is for validation purposes and should be left unchanged.

Thank you for filling in the questionnaire and taking part in the research.

What is required of you:

Fill in the questionnaire before you start
Listen to the Carefree Periods Apphirmations every night (or while you go about your day)
Fill in the Questionnaire after you completed the Carefree Apphirmations set
Fill in the questionnnaire again, 30 days after completing the set.

Play the Carefree Periods Apphirmations