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Womens Center - Incontinence

Page 1 Questions

1. Do you often have an uncomfortable and/or uncontrollable urge to urinate? *This question is required.
2. Do you wake up more than once per night to go to the restroom? *This question is required.
3. When you get the urge to go, do you have trouble making it to the bathroom? *This question is required.
4. Do you have the urge to go to the restroom more than every 2 hours? *This question is required.
5. Do you leak urine when you cough, sneeze, laugh or exercise? *This question is required.
6. Does your bladder leakage interfere with your daily activities? *This question is required.
7. Are you constantly keeping track of where the bathroom is in case you need one fast? *This question is required.
8. Are you limiting your fluids so you don’t leak as often? *This question is required.
*This self-assessment is provided for informational purposes only and is not intended for direct diagnostic use or medical decision-making without review and oversight by a clinical professional.