Skip to content
Go to Home » Urinary Symptoms » BFLUTS-SF questionnaire

BFLUTS-SF questionnaire

"*" indicates required fields

Step 1 of 3

Name*

We would like to find out about your symptoms and we are very grateful that you can help us by filling in this questionnaire. Please answer each question, thinking about the symptoms you have experienced in the last month.

You will see that some questions ask how often you have a symptom:

Occasionally Less than one third of the time
Sometimes Between one and two thirds of the time
Most of the time More than two thirds of the time

F1 - F4

During the night, how many times do you have to get up to urinate, on average?*
Do you have to rush to the toilet to urinate?*
Do you have pain in your bladder?*
How often do you pass urine during the day?*

V1 - V3

Is there a delay before you can start to urinate?*
Do you have to strain to urinate?*
Do you stop and start more than once while you urinate?*