Prostate Cancer – Self Assessment

Prostate cancer

Men over the age of 40 are at a higher risk of developing prostate cancer. Prostate cancer is highly treatable if detected early. This questionnaire is designed to help you and your physician identify whether you are currently showing any signs of prostate cancer problems. This questionnaire does not replace regular visits to your doctor for prostate cancer screening but merely lists factors, which could be indicative of prostate problems.

Each question has several responses from which you are asked to choose the one that best describes your own situation. Please be sure that you select only one response per question.

Please ensure all information is completed correctly in order for us to respond to your assessment promptly.

Self Assessment - Prostate Cancer

Over the past six months:

Submit your self assessment form to the Mens Clinic International Doctor for evaluation:

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