Participant Information and Consent Form

THE MALE PELVIC PAIN IMPACT QUESTIONNAIRE ROUND ONE

Investigators: Rema Annous, Jane Chalmers, Rocco Cavaleri

Purpose of the study
The aim of this Round One survey is for our team of researchers to understand what activities are impacted in men with pelvic pain. 

We are looking for men who are over 18 years of age and CURRENTLY experiencing pelvic pain. 

Your involvement
You will be asked questions about your pelvic pain and how it impacts your life. This survey is anonymous so please be AS HONEST AS YOU CAN BE.
 
Where you would like to provide more information on an impact area you have selected, or would like to add your own impact area, please use the 'other' box provided below each question. 

All information will be kept private and confidential. We will ask for your email address at the end to send you a reminder for the next round. 

If you have understood all the details involved and are willing to participate in the study, please select “I agree”. 

You are free to withdraw from this study at any time, simply by closing your web browser. 


Thank you for your participation.  

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* 1. Do you agree to the above terms?

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