NorthShore Bladder Health Quiz

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Bladder Health Quiz Form

1. Are you Male or Female?
2. Do you have a sudden need to rush to the toilet to urinate?
3. Do you sometimes not make it to the bathroom on time?
4. How often do you urinate during the day?
5. Do you get up 2 or more times throughout the night to urinate?
6. Do you experience a loss of urine when exercising?
7. Do you experience a loss of urine when you cough or sneeze?
8. Do you experience a loss of bowel control?

 

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