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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. Copies of the questionnaire in English are available below. To gain access to the scoring and interpretation materials, please register.

Translations: Translations are not available on the website and may require a fee depending on the details of your study. Pharmaceutical clinical trials tend to require licensing fees per language/per questionnaire, whereas fees are typically waived for investigator-initiated studies. Please register, indicating the country and 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, send a message to information@facit.org. Please confirm the translation of the questionnaire you'd like to use exists before registering. For a current list of language availability for each questionnaire, place your cursor over "Language Availability" and a list will appear. If you register for questionnaire that is not available, we will not respond to your registration. Note that the FACIT questionnaires undergo a rigorous translation and linguistic validation methodology, including cognitive debriefing with patients, and that unauthorized translations of our scales will not be recognized as official versions. To request translations of our questionnaires not currently available, visit the FACITtrans portion of this website.

The English versions of our questionnaires are free for anyone to use. 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.

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)

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Scoring & Interpretation Materials

FACT-G7: Functional Assessment of Cancer Therapy - General - (7 item version; be used with patients of any tumor type)

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Scoring & Interpretation Materials

FACT-GP: Functional Assessment of Cancer Therapy - General Population

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Scoring & Interpretation Materials

FANLTC: Functional Assessment of Non-Life Threatening Conditions

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Scoring & Interpretation Materials

 
CANCER SPECIFIC MEASURES

FACT-B: For patients with Breast cancer

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Scoring & Interpretation Materials

FACT-Bl: For patients with Bladder cancer

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Scoring & Interpretation Materials

FACT-Br: For patients with Brain cancer

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Scoring & Interpretation Materials

FACT-C: For patients with Colorectal cancer

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Scoring & Interpretation Materials

FACT-CNS: For patients with cancer in the Central Nervous System

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Scoring & Interpretation Materials

FACT-Cx: For patients with cancer of the Cervix

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Scoring & Interpretation Materials

FACT-E: For patients with Esophageal cancer

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Scoring & Interpretation Materials

FACT-En: For patients with Endometrial cancer

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Scoring & Interpretation Materials

FACT-Ga: For patients with Gastric Cancer

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Scoring & Interpretation Materials

FACT-H&N: For patients with Head & Neck cancer

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Scoring & Interpretation Materials

FACT-Hep: For patients with Hepatobiliary cancer (liver, bile duct and pancreas)

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Scoring & Interpretation Material

FACT-L: For patients with Lung cancer

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Scoring & Interpretation Materials

FACT-Leu: For patients with Leukemia

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Scoring & Interpretation Materials

FACT-Lym: For patients with Lymphoma (NHL)

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Scoring & Interpretation Materials

FACT-M: Functional Assessment of Cancer Therapy - Melanoma

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Scoring & Interpretation Materials

FACT-MM: Functional Assessment of Cancer Therapy - Multiple Myeloma

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Scoring & Interpretation Materials

FACT-NP: For patients with Nasopharyngeal cancer

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Scoring & Interpretation Materials

FACT-O: For patients with Ovarian cancer

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Scoring & Interpretation Materials

FACT-P: For patients with Prostate cancer

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Scoring & Interpretation Materials

FACT-V: For patients with Vulva cancer

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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)

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Scoring & Interpretation Materials

FBlSI: For patients with Bladder cancer; a FACT-Bladder Symptom Index (a subset of FACT-Bl containing 7 items)

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Scoring & Interpretation Materials

NCCN-FACT FBlSI: For patients with Bladder cancer; A FACT/NCCN-Bladder Symptom Index

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Scoring & Interpretation Materials

FBrSI: For patients with Brain cancer; a FACT-Brain Symptom Index (a subset of FACT-Br containing 15 items)

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Scoring & Interpretation Materials

NCCN-FACT FBrSI: For patients with Brain cancer; A FACT/NCCN-Brain Symptom Index

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Scoring & Interpretation Materials

FBSI: For patients with Breast cancer; A FACT-Breast Symptom Index (a subset of FACT-B containing 8 items)

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Scoring & Interpretation Materials

NCCN-FACT FBSI-16: For patients with Breast cancer; a FACT/NCCN-Breast Symptom Index

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Scoring & Interpretation Materials

FCSI: For patients with Colorectal cancer; A FACT-Colorectal Symptom Index (a subset of FACT-C containing 9 items)

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Scoring & Interpretation Materials

NCCN-FACT FCSI-19: For patients with Colorectal cancer; a FACT/NCCN-Colorectal Symptom Index

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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)

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Scoring & Interpretation Materials

NCCN-FACT FHNSI-22: For patients with Head & Neck cancer; a FACT/NCCN-Head & Neck Symptom Index

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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)

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Scoring & Interpretation Materials

NCCN-FACT FHSI-18: For patients with Hepatobiliary cancer (liver, bile duct and pancreas); a FACT/NCCN-Hepatobiliary Symptom Index

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Scoring & Interpretation Materials

FKSI-15: For patients with Kidney Cancer, a 15 item scale

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Scoring & Interpretation Materials

FKSI-10: For patients with Kidney Cancer, a 10 item scale

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Scoring & Interpretation Materials

FKSI-DRS: For patients with Kidney cancer; a 9 item scale of Disease Related Symptoms

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Scoring & Interpretation Materials

NCCN-FACT FKSI-19: For patients with Kidney cancer; a FACT/NCCN Symptom Index

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Scoring & Interpretation Materials

FLSI: For patients with Lung cancer; A FACT-Lung Symptom Index (a subset of FACT-L containing 6 items)

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Scoring & Interpretation Materials

FLSI-12: For patients with Lung cancer; a FACT-Lung Symptom Index (a subset of FACT-L containing 12 items)

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FACT-LCS:For patients with Lung cancer; a FACT-Lung Symptom Index (a subset of FACT-L containing 7 items)

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FACT-PSI:For patients with Lung cancer; a Pulmonary Symptom Index

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Scoring & Interpretation Materials

NCCN-FACT FLSI-17:For patients with Lung cancer; a FACT/NCCN-Lung Symptom Index

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Scoring & Interpretation Materials

NCCN-FACT FLymSI-18: For patients with Lymphoma (NHL); a FACT/NCCN-Lymphoma Symptom Index

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Scoring & Interpretation Materials

FOSI: For patients with Ovarian cancer; A FACT-Ovarian Symptom Index (a subset of FACT-O containing 8 items)

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Scoring & Interpretation Materials

NCCN-FACT FOSI-18: For patients with Ovarian cancer; a FACT/NCCN-Ovarian Symptom Index

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Scoring & Interpretation Materials

FPSI: For patients with Prostate cancer; A FACT-Prostate Symptom Index (a subset of FACT-P containing 8 items)

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Scoring & Interpretation Materials

NCCN-FACT FPSI-17: For patients with Prostate cancer; a FACT/NCCN-Prostate Symptom Index

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Scoring & Interpretation Materials


 
TREATMENT SPECIFIC MEASURES

FACIT-TS-BTCSQ: Bone Treatment Convenience and Satisfaction Questionnaire

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Download On Therapy WORD | Download On Therapy PDF
Language Availability

FACT-EF: For patients receiving Enteral Feeding

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Scoring & Interpretation Materials

FACT-AntiA: For patients receiving Anti-Angiogenesis therapy

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Scoring & Interpretation Materials

FACT-EGFRI-18: For patients treated with EGFR Inhibitors

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Scoring & Interpretation Materials

FACT&GOG-Ntx: For patients with Neurotoxicity

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Scoring & Interpretation Materials

FACT&GOG-Ntx12: For patients with Neurotoxicity

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Scoring & Interpretation Materials

FACT&GOG-Ntx13: For patients with Neurotoxicity

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Scoring & Interpretation Materials

FACT/GOG-Ntx4: For patients with Neurotoxicity

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Scoring & Interpretation Materials

FACT-BMT: For patients undergoing Bone Marrow Transplantation

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Scoring & Interpretation Materials

FACT-BRM: For patients receiving Biologic Response Modifiers

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Scoring & Interpretation Materials

FACT-Taxane: For patients receiving Taxane therapy

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Scoring & Interpretation Materials

FACT-Bl-Cys: For patients undergoing cystectomy (formerly FACT-VCI)
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Scoring & Interpretation Materials
 
SYMPTOM SPECIFIC MEASURES

FAACT: Functional Assessment of Anorexia/CachexiaTreatment

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Scoring & Interpretation Materials

FACIT-AD: For patients with Abdominal symptoms

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Scoring & Interpretation Materials

FACIT-AI: For patients with Ascites

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Scoring & Interpretation Materials

FACIT-CD: For patients with Cervical Dysplasia

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Scoring & Interpretation Materials

FACIT-D: For patients with Diarrhea

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Scoring & Interpretation Materials

FACIT-F: Functional Assessment of Chronic Illness Therapy-Fatigue

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Scoring & Interpretation Materials

FACIT-Fatigue: Functional Assessment of Chronic Illness Therapy-Fatigue; a 13-item FACIT Fatigue Scale

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Scoring & Interpretation Materials

FACT-An: For patients with Anemia/Fatigue

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Scoring & Interpretation Materials

FACT-B+4: For patients with Lymphedema (to be used with FACT-B)

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Scoring & Interpretation Materials

FACT-Bone Pain: For patients with Bone Pain

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Scoring & Interpretation Materials

FACT-Cog: For patients with Cognitive function issues

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Scoring & Interpretation Materials

FACT-ES: For patients with Endocrine Symptoms

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Scoring & Interpretation Materials

FACT-N: For patients with Neutropenia

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Scoring & Interpretation Materials

FACT-Th11: For patients with Thrombocytopenia

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Scoring & Interpretation Materials

FACT-Th18: For patients with Thrombocytopenia

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Scoring & Interpretation Materials

FAIT-F: Functional Assessment of Incontinence Therapy - Fecal

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Scoring & Interpretation Materials

FAIT-U: Functional Assessment of Incontinence Therapy - Urinary

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Scoring & Interpretation Materials


NON-CANCER SPECIFIC MEASURES

COST: A FACIT Measure of Financial Toxicity

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Scoring & Interpretation Materials

FACIT-Dyspnea: Functional Assessment of Chronic Illness Therapy - Dyspnea

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Scoring & Interpretation Materials
Download WORD 33 item | Download PDF 33 item
Scoring & Interpretation Materials - UNAVAILABLE

Language Availability

FACIT-Pal: Functional Assessment of Chronic Illness Therapy - Palliative Care

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Scoring & Interpretation Materials

FACIT-Pal-14: Functional Assessment of Chronic Illness Therapy - Palliative Care 14-item version

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Scoring & Interpretation Materials

FACIT-Sp: Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being

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Scoring & Interpretation Materials

FACIT-Sp-12: Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being; The 12-item Spiritual Well-Being Scale

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Scoring & Interpretation Materials

FACIT-Sp-Ex: Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being, Expanded version

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Scoring & Interpretation Materials

FACIT-Sp-Non-Illness: Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being, a modified version for non-illness

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Scoring & Interpretation Materials

FACIT-SWiP: Satisfaction with Pharmacist Scale

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Scoring & Interpretation Materials

FACIT-TS-G: Functional Assessment of Chronic Illness Therapy - Treatment Satisfaction - General

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Scoring & Interpretation Materials

FACIT-TS-PS: Functional Assessment of Chronic Illness Therapy - Treatment Satisfaction - Patient Satisfaction

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Scoring & Interpretation Materials

FAHI: Functional Assessment of HIV Infection

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Scoring & Interpretation Materials

FAMS: Functional Assessment of Multiple Sclerosis

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Scoring & Interpretation Materials


PEDIATRIC MEASURES


Peds-FAACT: Pediatric - Functional Assessment of Anorexia Cachexia

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Peds-FAACT-10: Pediatric - Functional Assessment of Anorexia Cachexia- 10 item version

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Soring & Interpretation Materials

Peds-FACT-Br: Pediatric - For patients with Brain cancer

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Scoring & Interpretation Materials

Peds-FACIT-F: Pediatric - Functional Assessment of Chronic Illness Therapy-Fatigue

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Scoring & Interpretation Materials