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Survey on Contraceptive Devices

1. How many kids do you have?

One

Two

Three

2. What is your age?

Under 18

18-24

25-34

35-44

3. Have you ever used a contraceptive?

Yes

No
4. Which type of contraceptive you have used?

Condoms

IUDs

Contraceptive pills

Contraceptive Implant

Contraceptive ring

Contraceptive Diaphragm

Contraceptive Injection

5. For how much time period you had used the contraception?

3-6 months

12 months

1-3 years

6. Have you taken precautions during the use of comtraceptive?

Yes

No
7. Do you had any side effects while using contaception?

Yes

No

8. What type of side effects you had while using contraception?

Vaginal Bleeding

Irregular Periods

Skin Irritation

Weight gain

Urinary Tract Infection

9. After side effects, what type of treatment have you taken?

Removal of contraceptive

Prescribed medicine

Change of contraceptive

10. Are you feeling better now?

Yes

No
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