Patient Forms & Instructions

Your provider may ask that you complete or review the following forms and information.

For new patients:

• New Patient Letter
  Welcome information to prepare you for your first appointment.
   
• Patient History Form
  Questionnaire regarding your medical history and symptoms.

Diagnostic testing:

• Urodynamics/Cystoscopy Information Pamphlet
  What to expect during urodynamic testing.

Post-operative instructions:

• Post-Operative Instruction Sheet
  Instructions for care after your surgery.

General information and instructions:

• Bladder Diary
  A form to help you track your fluid intake and output for a 24-hour period.
   
• Bladder Drills/Timed Voids
  Instructions for bladder drills/timed voids that may help you urinate less frequently.
   
• Bladder Irritants
  Listing of foods and beverages that have been linked to symptoms of urinary frequency, urgency, urge incontinence or bladder pain.
   
• Bowel Regularity
  Information to prevent constipation and promote bowel regularity.
   
• Fiber Information Sheet
  Guidelines for following a high-fiber diet.
   
• General Vulvar Care
  "Do"s and "don’t"s to keep the vulva dry and free from irritants.
   
• Instructions for Patients with Catheter Bags
  Tips for the use and care of catheter bags.
   
• Self-Catheterization Instruction Sheet
  Instructions for self-catheterization to help you empty your bladder.
   
• Self-Catheterization Record
  A chart to track self-catheterization.
   
• Vaginal Lubrication Products
  Product recommendations and descriptions for vaginal lubrication.