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Providers
Locations
Specialties
Cardiology
Dermatology & Plastic Surgery
Endocrinology
Gastroenterology
Gynecology
Internal Medicine
Nephrology
Neurology
Podiatry
Pulmonology
Rheumatology
Urology
Lab & Imaging
Careers
Patient Portal
Contact Us
About Us
Contact Us
Patient Portal
Billing & Insurance
Patient Rights and Responsibilities
Forms
Research
Radiology Prep Guide
Overactive Bladder & Incontinence Quiz
Do you have an uncomfortable and/or uncontrollable urge to urinate?
Yes
No
Are you bothered by frequent urination during the daytime hours?
Yes
No
When you get the urge to go, do you make it to the bathroom on time?
Yes
No
How long can you wait between bathroom trips to urinate?
5 hours or more
4 hours
3 hours
2 hours or less
At night, do you get up to use the bathroom?
Yes
No
Does urine leak when you: (check all that apply)
Cough or sneeze
Exercise
Laugh hard
Lift something
Engage in sexual activity
None of the above
How long have you had these symptoms?
They just started
Less than 6 months
1-2 years
3 years or more
To help your symptoms, have you tried (check all that apply):
Changing how often you drink fluid or how much fluid you drink
Wearing pads or briefs
Keeping a bladder diary
Doing Kegel exercises
Sticking to a bathroom schedule
Surgeries or procedures
None of the above
Have you ever had treatment for these symptoms?
Yes
No
What type of treatment have you received?