Vaginal Steaming Screening
This assessment will allow me to help you find out if you are a good candidate for vaginal steaming. If you are a candidate, I will guide you with your customize vaginal steaming setup that you can perform at home.
Email address *
Name *
Date *
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Contraindications
There are times when it is not beneficial for a woman to steam. First, let's check and make sure that you don't have any contraindications.
Are you on your menstruation? *
Do you currently have fresh spotting? *
Do you ever have spontaneous bleeding? *
Do you ever have two periods per month? *
Do you have an infection characterized with a burning itch? *
Are you pregnant? *
If trying to conceive, are you past ovulation? *
Do you have tubal coagulation (burning of the fallopian tubes through laparoscopic surgery through the belly button)? *
Do you have a birth control arm implant (i.e. nexplanon)? *
Important!
The above "Yes" replies indicate that vaginal steaming is contraindicated. It is not safe and could result
in negative side effects such as the onset of bleeding, an outbreak, a miscarriage or a birth control
failure. Steaming should not be performed at this time. If a birth control contraindication, it is up to the
client whether or not she would like to do the steam session with the possible pregnancy risk.
If a birth control contraindication, please indicate if you would like to do the session with the possibility of pregnancy risk? (Answer "Yes", if you have NO contraindications and would like to move forward.) *
If you answered, "Yes" to the above question, type your name and date to indicate that you understand that birth control can fail with vaginal steaming.
Name and Date REQUIRED to move forward with steaming recommendations from me.
Name
Date
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