Pelvic Health Questionnaire "*" indicates required fields Do you accidentally leak urine when you exercise, laugh, cough or sneeze?* Yes No Sometimes Do you experience discomfort during gynecological examinations (specifically a Pap test) or during intimacy?* Yes No Sometimes Do you wake up to go to the bathroom more than once a night?* Yes No Sometimes Do you have sudden, intense urges to urinate that get worse while getting closer to the bathroom?* Yes No Sometimes Are your current symptoms interrupting your everyday life, causing you to constantly plan your life around bathroom breaks?* Yes No Sometimes
