gender, age

  female under 14
  female 15-30
  female 31-70
  male under 14
  male 15-30
  male 31-70

when did you last pee your pants

  last year
  never
  today
  last week
  last month

why did you last pee your pants

  not allowed to use bathroom
  waited to long
  drunk
  wanted to
  bladder infection

was it a true accedent

  yes
  no

what did you do

  grab your self
  cry
  run
  give up and let it out
  poop
  all of the above

when did you last wet the bed

  last year
  last night
  last month
  never