1. Getting pregnant now would interfere with my plans.

Yes No

2. Pregnancy is a few years off for me.

Yes No

3. Taking my birth control at the same time every day can be difficult to remember.

Yes No

4. Getting my birth control prescription refilled monthly can be a hassle.

Yes No

5. I sometimes forget to take my birth control pill.

Yes No

6. If my periods change, and after 3 to 6 months become lighter, I'd be OK with that.

Yes No