The following questions ask about your feelings and experiences regarding the impact of hemorrhoid bleeding symptoms on your life. Please consider each question as it relates to your experiences with hemorrhoid bleeding during the previous 3 months. There are no right or wrong answers. Please be sure to answer every question by checking the most appropriate box. If the question does not apply to you, please check “none of the time” as your option.
During the previous 3 months, how often have your symptoms related to hemorrhoid bleeding: