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Vasectomy Survey

Plan V is collecting anonymous data, and we need your help. Answer if you do not currently have a vasectomy.

We are a 501c3 public benefit nonprofit, meaning we must fundraise and apply for grants to help us expand vasectomy awareness and access.

Martial Status
Married/Legal Domestic Partnership
Unmarried
Insurance Status
None
Little or poor coverage
Yes but won't cover vasectomies
Medicaid
Yes, unsure if good or will cover
Employment Status
Unemployed
Part-Time (less than 30 hrs/week)
Full-Time (30 hrs/week or more)
Freelance, Contract Work or Self-Employed with varying hours her week
If employed, does your job require heavy lifting and/or active movement throughout the day?
Yes
No
How long have you been considering a vasectomy?
Less than 6 months
6 months - 2 years
2+ years
How confident are you that vasectomy is the right choice for you?
100% confident
Mostly confident but I still have some nervousness or concerns
Not very confident and/or nervous
Who is encouraging you to have a vasectomy?
Myself
My sexual partner
A friend or family member
A healthcare provider
Social media/the general public
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