• Womenin Canada with Fibroids

    Nearly 3 of 4 women will have experienced
    Fibroids by age 50.

    A significant number of those will endure life altering symptoms.

  • Womenin Canada with Fibroids

    Yes, most of you CAN manage your fibroids symptoms with little hassle.

    Often the simple remedies around us help when taken properly.

  • Womenin Canada with Fibroids

    It's time we talked openly about this business of fibroids don't you think?

    And it's high time we demand some action too.

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A Network of Canadian Women seeking information on Fibroids and the Treatments currently available for Fibroids in Canada.

Form for your First Visit to the Specialist

When you fill in this form, your email will receive a perfectly formatted document to take with you to your First (or early) GYN Visit for Fibroids. The idea of this form is to save you visits, by having all this info handy you arm your specialist with more tools to work toward the solutions you want. As well, your email will contain links to good reading on any of the treatments of interest you check off. Completing this form helps you talk to your GYN fully informed and holding all relevant information. (Your information is not shared with, or sold to, any third parties; it is collected in order to supply you with the best possible information for your GYN visit).

save visits, save time ...

Your Full Name*
Your name will be on your form for easy filing at the GYN.

Email Address*
Where your printable report should be sent


Date you noticed symptoms began*
Invalid Input

1st 2 Period Days: Bleeding is...*
About the first couple days of your period..

Scroll down and select one

Last Period Days: Blood Loss is...*
Indicate the last few days blood loss during your periods

Average Period Duration?*
What is the average duration of your periods?

Any Spotting?*
Let your GYN know about any spotting

Check Usual Symptoms*
Click all symptoms that apply to you

Hold CTRL Key & click all that apply

Do you experience Clotting?

Fertility is...*
Choose a status on Fertility for yourself

Current Medications: Check off any medications that your GP may have prescribed or any pain killer you have been using to assist in treating symptoms.

Anything you Currently Take for Fibdrods*
Invalid Input

Hold CTRL Key & click all that apply

Treatments of Interest*
Invalid Input

Hold CTRL Key & click all that apply