BAVBIO BV Symptoms Questionnaire BVSQ Bacterial Vaginosis Symptoms Questionnaire Participant ID(Required) Product Number(Required)Timepoint(Required) Day 1 of Symptoms Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Day 8 Day 9 Day 10 Day 11 Day 40 Part 1. Physical SymptomsInstructions: Rate your current vaginosis symptoms from 0 (no symptom/not present) to 10 (worst possible)(Required)0 (no symptom/not present) to 10 (worst possible)0 (no symptoms)12345678910 (worst possible)1. Vaginal odour2. Vaginal itch3. Vaginal discharge4. Vaginal discomfort e.g. from swelling, inflammation, tingling, burning etcPart 2. Appearance of discharge1. ColourPlease select the response/s that best describes the appearance of your vaginal discharge: choose 1-2 options max. No discharge Clear (like raw egg white) White Cream Yellow Greenish tinge Pink Brown 2. ConsistencyPlease select the response/s that best describes the appearance of your vaginal discharge: choose 1-2 options max. No discharge Thick (cottage cheese-like) Thin (watery) Sticky/pasty Creamy & smooth Frothy Dry/flaky Part 3. Quality of Life(Required)Please rate your current vaginosis symptoms on the following aspects of your life where 1 = very negative, 2 = negative, 3 = neutral, 4 = positive, 5 = very positive 1 (very negative)2 (negative)3 (neutral)4 (positive)5 (very positive)1. Interactions with others2. Relationship3. Mental health4. Physical health5. Overall quality of lifeSwabs and pH TestAs this is Day 1 of your symptoms, please collect the vaginal swabs as per the instructions provided. Take the purple lid kit swab (as soon as possible) to your local SNP Laboratory along with the enclosed form. Store the second swab (white cap kit) in your fridge. Please also perform a vaginal pH test as per the instructions provided and record the result below.As this is Day 11 of your symptoms, please collect another vaginal swab as per the instructions provided. Send this swab (as soon as possible) along with the one stored in your fridge from Day 1 to the testing laboratory in the supplied pre-addressed reply paid envelope. Please also perform a vaginal pH test as per the instructions provided and record the result below.As this is Day 40, please collect a final vaginal swab as per the instructions provided. Send this swab (as soon as possible) to the testing laboratory in the supplied pre-addressed reply paid envelope. Please also perform a final vaginal pH test as per the instructions provided and record the result below.Please record your results from the pH test below: Concomitant medicationsAre you currently experiencing any other other illnesses or taking any new medications?If you indicate that you've had a change to your general health or regular medications, one of our friendly Trial Coordinators will be in touch soon to ask some additional questions. Yes No
