Perimenopause/Menopause Patient Forms

You may download and complete the fillable forms below and bring with you to your next appointment.


Click link below and save file to your desktop

New Patient Intake Form (fillable PDF) →

New Patient Intake Form


Click link below and save file to your desktop

Menopause Rating Scale (PDF)→

Menopause Rating Scale


Click link below and save file to your desktop

Female Sexual Function Index (PDF) →

Female Sexual Function Index


Click link below and save file to your desktop

Female Distress Scale (PDF) →

Female Distress Scale (Prior Treatment )


Click link below and save file to your desktop

Vulvovaginal Questionnaire (PDF) →

Vulvovaginal Questionnaire


Click link below and save file to your desktop

Vulvar Pain Questionnaire (PDF) →

Vulvar Pain Functional Questionnaire