Vulvar Pain Functional Questionairre (V-Q)These are statements about how your pelvic pain affects your everyday life. Please check one box for each item below, choosing the one that best describes your situation. Some of the statements deal with personal subjects. These statements are included because they will help your health care provider design the best treatment for you and measure your progress during treatment. Your responses will be kept completely confidential at all times.
*Check (1) choice for each question
© 2005 Kathie Hummel-Berry, PT, PhD, Kathe Wallace, PT, Hollis Herman MS, PT, OCS
All providers of women’s health services are hereby given permission to make unlimited copies for clinical use.