Please select the score that applies best to your urinary conditions during the last week.

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* 1. Do you leak urine (even small drops), wet yourself, or wet your pads or undergarments when you cough or sneeze?

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* 2. Do you leak urine (even small drops), wet yourself, or wet your pads or undergarments when you bend over or lift something up?

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* 3. Do you leak urine (even small drops), wet yourself, or wet your pads or undergarments when you walk quickly, jog, or exercise?

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* 4. Do you leak urine (even small drops), wet yourself, or wet your pads or undergarments while you are undressing in order to use the toilet?

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* 5. Do you get such a strong and uncomfortable need to urinate that you leak urine (even small drops) or wet yourself before reaching the toilet?

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* 6. Do you have a rush to the bathroom because you get a sudden, strong need to urinate?

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