DiVa Self-Assessment Thank you for completing the diVa™ Candidacy Quiz. Based on your results, it appears that you are a candidate for diVa. We understand that you may be experiencing more symptoms than the ones just listed, and we plan to address all of your symptoms and concerns. In order to best serve you, we need to review your medical history. Click HERE to complete and submit your initial sexual medicine consultation form. Once our providers have reviewed your medical history and determined whether you may be eligible, we will contact you to schedule a consultation to discuss a customized treatment plan and cost. Are You a Candidate for diVa™? Do you experience vaginal dryness?YesNo Do you have urinary incontinence or have a hard time getting to the bathroom on time?YesNo Are you experiencing a decrease in your libido or sexual satisfaction?YesNo Have you given birth vaginally to at least one child?YesNo Name* First * Last Email* By providing your email, you will be subscribed to our bi-weekly newsletter with health and beauty tips, delicious recipes, fresh links, and more. You can unsubscribe at any time. What are you interested in?Hormone Replacement Therapy (HRT)Joint & Tendon PRPSexual MedicineMedSpaWeight Loss
