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Candida Questionnaire

Score Sheet

This questionnaire is designed for adults and the scoring system isn't appropriate for children. It lists factors in your medical history which promote the growth of the common yeast, Candida Albicans (Section A), and symptoms commonly found in individuals with yeast-connected illness (Sections B and C).

For each “Yes” answer in Section A, check the box in that section. Your total score will calculate at the bottom of the section. Then move on to Sections B and C and complete as directed.

Filling out and scoring this questionnaire should help you and your provider evaluate the possible role of yeasts in contributing to your health problems, but it will not provide an automatic “Yes” or “No” answer.

Section A: HISTORY

Have you taken antibiotics for acne for 1 month (or longer)?
Have you taken other antibiotics for 2 months or longer, or in shorter course multiple times in a single year?
Have ever you taken a broad spectrum antibiotic?
Have you, at any time in your life, been bothered by persistent prostatitis, vaginitis or other problems affecting your reproductive organs?
Have you been pregnant?
Have you taken birth control pills?
Have you taken steroids, such as prednisone or cortisone?
Does exposure to perfumes, insecticides, fabric shop odors or other chemicals provoke...
Are your symptoms worse on damp, muggy days or in moldy places?
Have you had athlete’s foot, ringworm, “jock itch” or other chronic fungal infections of the skin or nails?
Do you crave sugar?
Do you crave breads?
Do you crave alcoholic beverages?
Does tobacco smoke really bother you?