Medical Pages Ireland
 

Questionnaire

Print this questionnaire, and fill it in. If you are attending a professional with an interest in sweating, bring it along with you.

Are you ?
 Male
Female
What age are you ?
 14 - 25
26 - 35
36 - 50
Over 50
How long have you suffered from excessive sweating ?
1 year
1 - 5 years
More than 5 years
Do you have a relative with simular condition?
 Yes
No

What have you tried to help control your sweating up to now ?
 Stronger Antiperspirants e.g. Anhydrol
Prescription from doctor
Hypnotherapy
Botulinum Toxin
Iontophoresis
Surgery

Where does excessive sweating occur on your body?
Face/head
Upper Lip
Armpits
Hands
Feet
Trunk

What triggers your excessive sweating?
Nothing
Circumstances, e.g. stress at work
Social Events
Some foods drinks
Alcohol
Some types of clothing
How often do you change your clothes as a result of your excessive sweating?
I don't need to change
Once daily
Twice daily
3 Times or more daily
When the sweating is particularly bad, how often do you have to wash/dry the affected area?
 Once Daily
Twice Daily
3 or more times per day
Too many times to count
Where did you hear about this website?
Magazine/Newspaper
 From a friend
 On the radio
 On another website
 Search Engine
 Other
 


How does the excessive sweating affect your daily life ?
 
Significantly
Quite a bit
Moderately
Affects you developing a personal relationship
Affects you shaking hands
Affects you being in public
Affects you on family occasions
Affects you at work
Has stopped you following a career path