The Right Diagnosis Can Lead You to the Right Treatment

Interstitial Cystitis (IC) Symptom Questionnaire

The following IC Symptom Questionnaire, also known as the PUF Questionnaire,* is one of the tools that can be used to help evaluate the symptoms of IC. This short questionnaire will measure the symptoms associated with IC, based on pain, urgency, and frequency of urination. Complete all of the questions, print out the results, and then take it to your doctor.

For each question, please select the response that best describes how you feel. Then click the “See Results” button to go to a printable page you can take to your next appointment.

*Developed by C. Lowell Parsons et al; PUF Questionnaire (Pelvic Pain, Urgency, and Frequency) © 2002.