1. Are you experiencing painful urination?
A. Sometimes
B. No
C. Yes
2. Are you experiencing any abnormal or concerning discharge?
A. Sometimes
B. No
C. Yes
3. Are you experiencing any pain in your abdomen, testicles or during sex?
A. Sometimes
B. No
C. Yes
4. Are you experiencing any painful bowel movements?
A. Sometimes
B. No
C. Yes
5. Are you having any genital or anal itching?
A. Sometimes
B. No
C. Yes
6. Are you noticing any strange or unpleasant odors?
A. Sometimes
B. No
C. Yes
7. Are you seeing any rashes, bumps, blisters or sores?
A. Sometimes
B. No
C. Yes
8. Are you experiencing any bleeding in your genital area?
A. Sometimes
B. No
C. Yes
9. Have you had unprotected sex?
A. Sometimes
B. No
C. Yes
10. Have you had sex with more than one partner in your lifetime?
A. Yes, but I mostly took sexual precautions
B. Yes
C. No
