Have you ever experienced leakage of urine when exercising, laughing, coughing, sneezing?
Yes
No
Have you ever struggled with Severe Constipation?
Yes
No
Have you (in the past 3 months) or do you experience pain with penetration or intimacy?
Yes
No
Have you ever been pregnant or given birth?
Yes
No
Do you ever have to rush to the bathroom to pee or poop, and have trouble holding it?
Yes
No
Do you experience pressure or heaviness in your vagina throughout the day or at the end of your day?
Yes
No
Do you experience low back or hip pain that has not improved with other attempts to make it better?
Yes
No
Are you limited from exercising the way you want due to anything having to do with "down there"?
Yes
No
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