Sexual Transmitted Diseases Check-up Find out more about your health condition and the related services we offer, by completing in a simple health assessment.*This questionnaire is for reference only. It is not a medical diagnosing tool. 1. When is your last unprotected sexual intercourse? Within 7 days 1 week ago 2 weeks ago 1 month ago 3 months ago 2. Type of sexual intercourse(Multiple option) Oral Vaginal Sex Anal Sex 3. Please check if you infected with below STDs in the past (Multiple option) None Chlamydia Genital Warts Trichomoniasis Mycoplasma Ureaplasma Genital Herpes Gonorrhoea HPV Syphilis Others 4. When is your last diagnosis? Within 7 days 1 week ago 2 weeks ago 1 month ago 3 months ago 5. What symptoms do you have? (Multiple option) None Discharge Difficult Urination / Dysuria Other Itching Ulcer Lump Scrotal Pain Genital Itching Rash Others 6. Duration of symptoms occurred. Within 7 days 1 week ago 2 weeks ago 1 month ago 3 months ago Health Check-upErectile Dysfunction Check-up