Pelvic Floor Health Screening - Part 2 Please complete prior to 1st session Question Title * 1. Do you feel like there is a heaviness or pressure in your vagina or rectum (other than prior to eliminating) Never Sometimes All the time Question Title * 2. Do you have jaw pain or migraines, low back pain, knee pain, foot, leg, hip pain, pelvic, buttocks, abdominal or tailbone pain that is not associated to a fall or specific injury? If yes please list all areas that you have pain. Question Title * 3. Do you ever have the symptoms of a urinary tract infection, but your tests come back negative? Never Sometimes All the time Question Title * 4. Do you have tenderness or pain during intercourse or during orgasm or after intercourse? Never Sometimes All the time Question Title * 5. Have you experienced trauma from abuse or rape? yes No I am not sure Question Title * 6. Are you struggling with anxiety or stress? Never Sometimes All the time Question Title * 7. Do you sit for the most of your day? Never Sometimes All the time Question Title * 8. Do you exercise regularly or have a job/hobby that requires physical effort? If so, please list the types of activities. and how often you do them. Question Title * 9. Have you had a hysterectomy, episiotomy, prolapse repair, surgery for endometriosis, cyst or fibroids or any other pelvic surgery. If yes please list surgeries or list issues that you are trying to address. Question Title * 10. Are you approaching menopause or are in menopause? If so, are you on hormone replacement therapy? Have you had your hormones tested? Please end this question by indicating your name so that I can link this part of the survey to your part 1. Done. I completed part 1 as well