Female Questionnaire
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This section deals with antibiotic, antiviral, antifungal, and antiparasitic medication use.  Add a note with details where necessary.


Have you taken tetracyclines (for example Sumycin, Panmycin Vibramycin, Minocin) in the last 5 years?
  • No / don't know
  • For 1 month
  • For 1 to 2 months
  • For 2 to 3 months
  • For 4 months or longer


Have you taken other broad-spectrum antibiotics for urinary, respiratory or other infections within the last 5 years? Examples include Ciprofloxacin and Levofloxacin.
  • No / don't know
  • One course under 2 months
  • One course 2 months or longer
  • Two courses in a single year
  • Three or more courses in a single year


Are you currently using prescription antibiotics, antifungals, antivirals or other drugs to kill/control organisms? If you are, please answer this question and then list them. "Short term" is considered roughly 2 weeks or less.
  • No
  • Short term current use for a known infection
  • Short term current use for a suspected infection
  • Current use of 2 weeks to 3 months
  • Current use for longer than 3 months