The purpose of the survey is to help us understand if leaking urine affects your ability to exercise or if it affects the type of exercise and activity you do.

Leaking urine is commonly known as wetting yourself when you don’t mean to.

The survey will take approximately 10-15 minutes to complete.

Your answers are strictly confidential.

Your consent to participate is granted if you fill in and return this survey.

If you would like further details on this study or need help to answer any of the questions, please feel free to call us on (01) 8962604 or email:

Thank you for taking the time to complete this survey.

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* I understand that I am being asked to complete this survey now and to complete it again one week from now.

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* I understand that by filling in and returning this survey I give my consent to participate.