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For those who've wet their pants.

This test will ask you a number of questions that will show why, how often, and how recently different groups of people have peed in their pants.



1)

Are you male or female?

 
 
 

2)

How old are you? (For the next few questions, if your age doesn't appear, select none of the above, or your age if it appears in the choices below.)

 
 
 
 
 
 
 
 
 

3)

How old are you? (For the next few questions, if your age doesn't appear, select none of the above, or your age if it appears in the choices below.)

 
 
 
 
 
 
 
 
 

4)

How old are you? (For this question, if your age doesn't appear, select none of the above, or your age if it appears in the choices below.)

 
 
 
 
 
 
 
 
 

5)

Do you suffer from any type of incontinence? (Incontinence is a medical condition that your doctor can help you with, so if you answer yes please talk to your doctor.)

 
 
 
 
 
 

6)

Have you ever needed to pee so badly while trying to reach a bathroom that you were afraid you might pee yourself before you could get there?

 
 

7)

Have you ever relieved yourself in your clothing before? (Only answer yes if you've completely or mostly emptied your bladder in your clothes. I'm not talking about close calls or times where you barely made it with a small wet patch. I'm referring to those times where you didn't make it to the bathroom at all and completely wet yourself.

 
 
 
 
 
 
 
 

8)

How many times have you accidentally relieved yourself in your clothes? (Only count those times you just couldn't hold it in anymore and totally wet yourself.If the number doesn't appear below, select none of the above and move on to the next question.)

 
 
 
 
 
 
 
 
 

9)

How many times have you accidentally relieved yourself in your clothes? (Only count those times you just couldn't hold it in anymore and totally wet yourself.If the number doesn't appear below, select none of the above and move on to the next question.)

 
 
 
 
 
 
 
 
 

10)

How many times have you accidentally relieved yourself in your clothes? (Only count those times you just couldn't hold it in anymore and totally wet yourself.If the number doesn't appear below, select none of the above and move on to the next question.)

 
 
 
 
 
 
 
 
 

11)

How many times have you accidentally relieved yourself in your clothes? (Only count those times you just couldn't hold it in anymore and totally wet yourself.If the number doesn't appear below, select none of the above and move on to the next question.)

 
 
 
 
 
 
 
 
 

12)

How many times have you accidentally relieved yourself in your clothes? (Only count those times you just couldn't hold it in anymore and totally wet yourself.If the number doesn't appear below, select none of the above and move on to the next question.)

 
 
 
 
 
 
 
 
 

13)

How many times have you accidentally relieved yourself in your clothes? (Only count those times you just couldn't hold it in anymore and totally wet yourself.If the number doesn't appear below, select none of the above and move on to the next question.)

 
 
 
 
 
 
 
 
 

14)

How many times have you accidentally relieved yourself in your clothes? (Only count those times you just couldn't hold it in anymore and totally wet yourself.If the number doesn't appear below, select none of the above and move on to the next question.)

 
 
 
 
 
 

15)

Do you use public restrooms?

 
 
 
 
 
 

16)

How long ago was the last time you accidentally relieved yourself in your clothes? (If the length of time that applies to you doesn't appear below, select none of the above and move on to the next question.

 
 
 
 
 
 
 
 
 

17)

How long ago was the last time you accidentally relieved yourself in your clothes? (If the length of time that applies to you doesn't appear below, select none of the above and move on to the next question.)

 
 
 
 
 
 
 
 
 

18)

How long ago was the last time you accidentally relieved yourself in your clothes? (If the length of time that applies to you doesn't appear below, select none of the above and move on to the next question.)

 
 
 
 
 
 
 
 
 

19)

How long ago was the last time you accidentally relieved yourself in your clothes? (If the length of time that applies to you doesn't appear below, select none of the above and move on to the next question.)

 
 
 
 
 
 
 
 
 

20)

How long ago was the last time you accidentally relieved yourself in your clothes? (If the length of time that applies to you doesn't appear below, select none of the above and move on to the next question.)

 
 
 
 
 
 
 
 
 

21)

The last time you accidentally relieved yourself in your clothes, which of the following causes or reasons do you think most closely describes why you accidentally wet yourself?

 
 
 
 
 
 
 
 
 

22)

The last time you needed to pee so badly while trying to make it to the bathroom in time that you were afraid you might pee yourself before you could get there, on a scale from 0 to 7, how embarrassing was it to feel like you might start wetting yourself at any moment?

 
 
 
 
 
 
 
 
 

23)

The last time you accidentally relieved yourself in your clothes, how embarrassing was the experience on a scale from zero to 7?

 
 
 
 
 
 
 
 
 


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