Please print and complete the most relevant questionnaire, and bring this along with you to your first appointment.  It is helpful to complete these periodically over the course of your treatment to track your progress!

Patients with incontinence or pelvic pain, choose between V-Q and Pelvic Girdle which encompasses your symptoms. UEFI is for upper extremity (arms). LEFS is for lower extremity (legs).  Patients coming for visceral, patient functional is best.  Oswestry is for low back pain.  You do NOT have to complete more than one questionnaire.  Prolapse, urinary or fecal concerns, Pelvic Floor Disability Index. 

          Pelvic Floor Disability Index