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Questionnaires

Below is a list of all scales that are currently part of the FACIT Measurement System. Questionnaires and all related subscales, translations, and adaptations (“FACIT System”) are owned and copyrighted by David Cella, Ph.D. The ownership and copyright of the FACIT System resides strictly with Dr. Cella. Dr. Cella has granted FACIT.org the right to license usage of the FACIT System to other parties.

By downloading any of the questionnaires below, you agree to the following:

You must register your study on our website using the registration form. You are not required to provide any proprietary or confidential information. We will use this information in our website database for internal tracking purposes only. Registration will also automatically grant you access to the scoring and interpretation materials.

You will provide us with copies of any publications which come about as the result of collecting data with any FACIT questionnaire.

Due to the ongoing nature of cross-cultural linguistic research, we reserve the right to make adaptations or revisions to wording in the FACIT measurement system and/or related translations as necessary. If such changes occur,you have the option of using either previous or updated versions according to your research objectives. 

You may not change the wording or phrasing of any FACIT document without previous permission from us. If any changes are made to the wording or phrasing of any FACIT item without permission, the document cannot be considered FACIT and subsequent analyses and/or comparisons to other FACIT data will not be considered appropriate. Permission to use the name “FACIT” will not be granted for any unauthorized translations of the FACIT items. Any analyses or publications of unauthorized changes or translated versions may not use the FACIT name. Any unauthorized translation will be considered a violation of copyright protection.

In all publications and on every page of the FACIT used in data collection, the copyright information be listed precisely as it is listed on the questionnaire itself.

Translations: Translations are not available on the website and may require a fee depending on your study details. Please register, indicating the country or language you'd like, and we will contact you (either with the questionnaire or to request further information). Make sure you enter your email address properly so that we're able to get in touch with you and make sure that you're able to receive emails from facit.org. If you do not hear from anyone within 5 days, please send a message to information@facit.org. For a current list of language availability for each questionnaire, place your cursor over "Request Documentation in Other Languages" for the questionnaire you are interested in using and a list will appear.

Note: If you previously registered and obtained a username and password prior to November of 2010, please re-register to obtain a new username and password.

Further information about terms of use can be found in the Copyright section under About Us.

GENERAL MEASURES FACT-G: Functional Assessment of Cancer Therapy - General (constitutes the core of all subscales; the FACT-G can be used with patients of any tumor type) Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-GP: Functional Assessment of Cancer Therapy - General Population Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FANLTC: Functional Assessment of Non-Life Threatening Conditions Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials   CANCER SPECIFIC MEASURES FACT-B: For patients with Breast cancer Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-Bl: For patients with Bladder cancer Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-Br: For patients with Brain cancer Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-C: For patients with Colorectal cancer Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-CNS: For patients with cancer in the Central Nervous System Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-Cx: For patients with cancer of the Cervix Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-E: For patients with Esophageal cancer Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-En: For patients with Endometrial cancer Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-Ga: For patients with Gastric Cancer Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-H&N: For patients with Head & Neck cancer Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-Hep: For patients with Hepatobiliary cancer (liver, bile duct and pancreas) Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-L: For patients with Lung cancer Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-Leu: For patients with Leukemia Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-Lym: For patients with Lymphoma (NHL) Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-M: Functional Assessment of Cancer Therapy - Melanoma Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-MM: Functional Assessment of Cancer Therapy - Multiple Myeloma Download WORD | Download PDF| Request Documentation in Other Languages Scoring & Interpretation Materials FACT-NP: For patients with Nasopharyngeal cancer Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-O: For patients with Ovarian cancer Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-P: For patients with Prostate cancer Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-V: For patients with Vulva cancer Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials CANCER SPECIFIC SYMPTOM INDEXES FAPSI 8: For patients with Prostate cancer; A FACT-Prostate Symptom Index (a subset of FACT-P containing 8 items) Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FBlSI: For patients with Bladder cancer; a FACT-Bladder Symptom Index (a subset of FACT-Bl containing 7 items) Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials NCCN-FACT FBlSI: For patients with Bladder cancer; A FACT/NCCN-Bladder Symptom Index Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FBrSI: For patients with Brain cancer; a FACT-Brain Symptom Index (a subset of FACT-Br containing 15 items) Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials NCCN-FACT FBrSI: For patients with Brain cancer; A FACT/NCCN-Brain Symptom Index Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FBSI: For patients with Breast cancer; A FACT-Breast Symptom Index (a subset of FACT-B containing 8 items) Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials NCCN-FACT FBSI-16: For patients with Breast cancer; a FACT/NCCN-Breast Symptom Index Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FCSI: For patients with Colorectal cancer; A FACT-Colorectal Symptom Index (a subset of FACT-C containing 9 items) Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials NCCN-FACT FCSI-19: For patients with Colorectal cancer; a FACT/NCCN-Colorectal Symptom Index Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FHNSI: For patients with Head & Neck cancer; a FACT-Head & Neck Symptom Index (a subset of the FACT-H&N containing 10 items) Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials NCCN-FACT FHNSI-22: For patients with Head & Neck cancer; a FACT/NCCN-Head & Neck Symptom Index Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FHSI: For patients with Hepatobiliary cancer (liver, bile duct and pancreas); A FACT-Hepatobiliary Symptom Index (a subset of FACT-Hep containing 8 items) Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials NCCN-FACT FHSI-18: For patients with Hepatobiliary cancer (liver, bile duct and pancreas); a FACT/NCCN-Hepatobiliary Symptom Index Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FKSI-15: For patients with Kidney Cancer, a 15 item scale Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FKSI-10: For patients with Kidney Cancer, a 10 item scale Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FKSI-DRS: For patients with Kidney cancer; a 9 item scale of Disease Related Symptoms Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials NCCN-FACT FKSI-19: For patients with Kidney cancer; a FACT/NCCN Symptom Index Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FLSI: For patients with Lung cancer; A FACT-Lung Symptom Index (a subset of FACT-L containing 6 items) Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FLSI-12: For patients with Lung cancer; a FACT-Lung Symptom Index (a subset of FACT-L containing 12 items) Download WORD | Download PDF | Request Documentation in Other Languages FACT-LCS:For patients with Lung cancer; a FACT-Lung Symptom Index (a subset of FACT-L containing 7 items) Download WORD | Download PDF | Request Documentation in Other Languages NCCN-FACT FLSI-17:For patients with Lung cancer; a FACT/NCCN-Lung Symptom Index Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials NCCN-FACT FLymSI-18: For patients with Lymphoma (NHL); a FACT/NCCN-Lymphoma Symptom Index Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FOSI: For patients with Ovarian cancer; A FACT-Ovarian Symptom Index (a subset of FACT-O containing 8 items) Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials NCCN-FACT FOSI-18: For patients with Ovarian cancer; a FACT/NCCN-Ovarian Symptom Index Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FPSI: For patients with Prostate cancer; A FACT-Prostate Symptom Index (a subset of FACT-P containing 8 items) Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials NCCN-FACT FPSI-17: For patients with Prostate cancer; a FACT/NCCN-Prostate Symptom Index Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials   TREATMENT SPECIFIC MEASURES FACIT-TS-BTCSQ: Bone Treatment Convenience and Satisfaction Questionnaire Download Baseline WORD | Download Baseline PDF Download On Therapy WORD | Download On Therapy PDF Request Documentation in Other Languages FACT-EF:For patients receiving Enteral Feeding Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-EGFRI-18: For patients treated with EGFR Inhibitors Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT&GOG-Ntx: For patients with Neurotoxicity Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT&GOG-Ntx12: For patients with Neurotoxicity Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT&GOG-Ntx13: For patients with Neurotoxicity Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT/GOG-Ntx4: For patients with Neurotoxicity Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-BMT: For patients undergoing Bone Marrow Transplantation Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-BRM: For patients receiving Biologic Response Modifiers Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-Taxane: For patients receiving Taxane therapy Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials   SYMPTOM SPECIFIC MEASURES FAACT: Functional Assessment of Anorexia/CachexiaTreatment Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACIT-AD: For patients with Abdominal symptoms Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACIT-AI: For patients with Ascites Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACIT-CD: For patients with Cervical Dysplasia Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACIT-D: For patients with Diarrhea Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACIT-F: Functional Assessment of Chronic Illness Therapy-Fatigue Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACIT-Fatigue: Functional Assessment of Chronic Illness Therapy-Fatigue; a 13-item FACIT Fatigue Scale Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-An: For patients with Anemia/Fatigue Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-B+4: For patients with Lymphedema (to be used with FACT-B) Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-Bone Pain: For patients with Bone Pain Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-Cog: For patients with Cognitive function issues Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-ES: For patients with Endocrine Symptoms Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-N: For patients with Neutropenia Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-Th11: For patients with Thrombocytopenia Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACT-Th18: For patients with Thrombocytopenia Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FAIT-F: Functional Assessment of Incontinence Therapy - Fecal Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FAIT-U: Functional Assessment of Incontinence Therapy - Urinary Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials NON-CANCER SPECIFIC MEASURES FACIT-Dyspnea: Functional Assessment of Chronic Illness Therapy - Dyspnea Download WORD 10 item | Download PDF 10 item Scoring & Interpretation Materials Download WORD 33 item | Download PDF 33 item Scoring & Interpretation Materials - UNAVAILABLE Request Documentation in Other Languages FACIT-Pal: Functional Assessment of Chronic Illness Therapy - Palliative Care Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACIT-Sp: Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACIT-Sp-12: Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being; The 12-item Spiritual Well-Being Scale Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACIT-Sp-Ex: Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being, Expanded version Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACIT-Sp-Non-Illness: Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being, a modified version for non-illness Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACIT-SWiP: Satisfaction with Pharmacist Scale Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACIT-TS-G: Functional Assessment of Chronic Illness Therapy - Treatment Satisfaction - General Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FACIT-TS-PS: Functional Assessment of Chronic Illness Therapy - Treatment Satisfaction - Patient Satisfaction Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FAHI: Functional Assessment of HIV Infection Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials FAMS: Functional Assessment of Multiple Sclerosis Download WORD | Download PDF | Request Documentation in Other Languages Scoring & Interpretation Materials PEDIATRIC MEASURES Peds-FAACT: Pediatric - Functional Assessment of Anorexia Cachexia Download WORD | Request Documentation in Other Languages Peds-FAACT-10: Pediatric - Functional Assessment of Anorexia Cachexia- 10 item version Download WORD | Download PDF | Request Documentation in Other Languages Peds-FACT-Br: Pediatric - For patients with Brain cancer Download WORD | Request Documentation in Other Languages Peds-FACIT-F: Pediatric - Functional Assessment of Chronic Illness Therapy-Fatigue Download WORD | Download PDF | Request Documentation in Other Languages