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Questionnaires & Outcome Measures

Common Forms used in Pelvic Health

Here is a selection of questionnaires and outcome measures Pelvic Health practitioners can use with clients at intake and to track treatment progress.

Australian Female Pelvic Floor Questionnaire

Download

Bladder Diary & Instructions

Download

Bowel Diary & Instructions

Download

CSI_Inventory_and_Scoring

Download

International Index of Erectile Function

Download

NIH Chronic Pain Index

Download: Male  Female

OAB-q Overactive Bladder Symptom Bother

Download

Patient Specific Functional Scale

Download

Pelvic Floor Distress Inventory

Download

Pelvic Floor Screening for Low Back, S-I joint and Hip Pain

Download

Pelvic Organ Prolapse Symptom Score

Download

Pelvic Pain Questionnaire

Download

PISQ-IR Scoring Instructions

Download

PISQ-IR: Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, IUGA-Revised

Download

Prolapse Quality of Life (P-QOL)

Download

PTSD Checklist and Sorting

Download

Rapid Assessment of Physical Activity (RAPA)

Download

Self Evaluation of Breathing Questionnaire

Download

The Beliefs Questionnaire

Download

The Carol Scale

Download

The Carol Scale Interpretation Scoring

Download

Vaginal Symptoms Postpartum

Download

Vulvovaginal Symptom Questionnaire

Download

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