Aunt Vadge's Super Tech Support Guide

1/10: Nuts and bolts

Email Address*

Enter Email Confirm Email

Name*

First Last

Age*

Date of Birth*

Height*

Weight*

Country*

I gender identify as*

I have a*

2/10: What's up!

How can we help you? Ask your question!*

3/10: About your vagina and urinary tract

I have urinary tract symptoms*

Yes, currently

Yes, sometimes

No, never

Not right now, but in the past

My urinary tract symptoms include*

Explain your other urinary tract symptoms

I have vaginal symptoms*

Yes

No/do not have a vagina

So far I have tried*

Please list other treatments*

I am confirmed clear of sexually transmitted infections*

Yes

I'm not sure

I have not been tested

I use a condom/barrier when I have sex*

During my period, my symptoms*

Worsen

Improve

Stay the same

I don't get periods

My recent vaginal symptoms include:*

Please explain other symptoms*

Odour*

Discharge*

The pain is around the:*

The itch is around the:*

Vulva (outside)

Vagina (inside)

Anal area

Itch moves

Vaginal pH*

In the past year, a medical doctor has diagnosed me with:*

Please explain*

Across my life, I have a history of*

Please explain*

I have had symptoms for*

Please give a summary of treatments tried so far and their outcomes:*

What do you think triggered your symptoms initially?*

4/10: A little bit of context

Do you have any allergies? Medicine, food, environmental

Please list medical diagnoses and underlying conditions

Have you ever been hospitalised or had surgery?

Did you have any major illnesses as a child or teenager?

Please give a quick overview of trends in biological family health if known (kidney stones, diabetes, blood pressure, genetic health markers, UTIs, allergies, autoimmune, thyroid, etc.)*

I have used/am using Accutane (isotretinoin) acne drug*

Yes, in the past

Yes, using now

Never used

Planning to use in future

I regularly use antihistamine medication*

Yes

Don't need

6/10: What you're getting out

Do you experience digestive issues on a regular basis?*

Yes

No

Please explain your digestive issues in more detail:

7/10: The invisible forces

Talk us through your energy levels (waxing and waning through the day, napping, fatigue, energy levels out of 10, 10 being the most energy)*

Talk us through how you sleep (bedtime, wake time, night terrors/paralysis, vivid dreams, no dreams, frequent waking, hard to drop off, etc.)*

Talk us through your anxieties and stressors (kids, parents, work, relationships, friendships, mental, emotional and spiritual health)*

8/10: Crunching the numbers

Upload recent vaginal and urinary microbiome tests, original PDFs from provider only (no screenshots)

Drop files here or

Accepted file types: pdf, Max. file size: 12 GB.

JUNO NOTE: if you have a Juno report, please visit your dashboard (app.juno.bio), click the share symbol, and add info@myvagina.com to share your results with My Vagina.

Upload raw DNA .zip file from MyHeritage, 23andme or Ancestry.com

Accepted file types: zip, Max. file size: 12 GB.

We can screen your DNA test for a handful of key markers These results are only used for support purposes. Please log into your provider's website and download the raw data file and upload here. Only accepted format is .zip.

9/10: Almost there!

Snapshot of your world*

Please explain how you're feeling*

Do you have any barriers to treatment? (tight budget, allergies, disability, full schedule, lots of travel, etc)

Anything else we need to know about you?

10/10: Well done! Just one last thing...

Consent to disclaimer*

Yes I agree!

Please note this disclaimer is a complex legal document. It essentially means that outside of Australia (where we are bound by Australian law) My Vagina and its practitioners and staff are not legally responsible for what happens to you and you engage with us and follow our recommendations at your own risk.

In saying this, we are qualified practitioners operating within the legal framework of Australia, and we take this very seriously! We will work hard for you within our capabilities and provide a high level of care.

MISCELLANEOUS LIMITATION OF LIABILITY
The client agrees they use My Vagina’s services at their own risk.

Client releases My Vagina, its officers, employees, directors, subsidiaries, principals, agents, heirs, executors, administrators, successors, assigns, instructors, guides, staff, participants, naturopaths, practitioners and related entities any way as well as the venue where the sessions are being held (if applicable) and any of its owners, executives, agents, or staff (hereinafter “Releasees”) from any and all damages that may result from any claims arising from any agreements, all actions, causes of action, contracts, claims, suits, costs, demands and damages of whatever nature or kind in law or in equity arising from my participation in the consultations.

Client accepts any and all risks, foreseeable or unforeseeable.

Client agrees that My Vagina will not be held liable for any damages of any kind resulting or arising from including but not limited to; direct, indirect, incidental, special, negligent, consequential, or exemplary damages happening from the use or misuse of My Vagina’s services or enrolment in the Program.

My Vagina assumes no responsibility for errors or omissions that may appear in any of the materials.

JURISDICTION
Your use of the My Vagina website and services and any dispute arising out of your use of it is subject to the laws of the Commonwealth of Australia.

These terms are governed by the laws of the Commonwealth of Australia and subject to the exclusive jurisdiction of the courts operating in Australia.

My Vagina’s website and resource materials may be accessed throughout Australia and overseas.

We make no representation that My Vagina’s website complies with the laws (including intellectual property laws) of any country outside Australia.

If you access My Vagina’s website from outside Australia, you do so at your own risk and are responsible for complying with the laws in the place where you access My Vagina’s website and services.