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vragen@stimezo-zwolle.nl

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Decision aid form

Use our decision aid and indicate your preferences

In preparation for the consultation, please fill in the decision form below so that we can give you tailored advice.

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If you are human, leave this field blank.

Naam *

E-mail *

Hoe vaak anticonceptie? *

How often do you want to think about contraception?

Every day

Once a week

Every month

Every 3 months

Every 3 years

Every 5 years

Geen bezwaar hormonen? *

Do you have no objection to using hormones?

I have no objection to the use of hormones.

I want to use contraception without hormones.

Last van menstruatie? *

Do you have problems with your periods?

I want to be able to regulate or postpone my periods myself.

I want to have less pain and/or blood loss during my period.

I would like to have my periods every month.

Privacy belangrijk? *

Is privacy important to you?

Others may know that I use contraception.

I do not want others to know that I use contraception.

Inbrengen door een arts? *

Insertion by a doctor?

I am happy for a doctor to insert the contraceptive.

I do not want the doctor to insert the contraceptive.

Vragen over je gezondheid *

Questions about your health (tick if applicable)

None of the questions below apply

Are you pregnant?

Are you 35 years or older and do you smoke?

Have you had a heart attack or stroke (CVA)?

Do you have a congenital heart disease?

Have you had a thrombosis in the legs or a pulmonary embolism?

Do you suffer from migraine with aura?

Are you known to have a blood coagulation disorder?

Do you use anticoagulants to prevent thrombosis?

Are you known to have high blood pressure?

Have you had a hormone-dependent (breast or uterine) cancer?

Do you have diabetes associated with vascular abnormalities?

Do you have a serious liver function disorder (such as acute hepatitis)?

Do you have unusual vaginal bleeding of which the cause is unknown?

Have you used growth hormone?

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Contact details

Abortion Clinic Stimezo Zwolle

Oosterlaan 14
8011 GC Zwolle

The Netherlands

E vragen@stimezo-zwolle.nl

T +31 (0)38-4217000
F +31 (0)38-4223188

Opening hours

Mondays – Thursdays
8:15 am – 4:15 pm

Fridays
8:15 am – 12:15 pm

Abortion Clinic Stimezo Zwolle

Stimezo Zwolle supports women who turn to our clinic as a result of an unwanted pregnancy in a professional and committed way.