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Your provider may ask that you complete or review the following forms and information. If you need help or more information, email the patient navigator at firstname.lastname@example.org.
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.
- Urodynamics/Cystoscopy Information Pamphlet
What to expect during urodynamic testing.
- 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.
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