OHSU

Patient Forms

Welcome to OHSU Urogynecology

 

New Patient Questionnaire

If you’re a new patient, please complete this questionnaire before your first visit. The form includes a diary that tracks important information about your fluid intake, frequency of urination, whether you had any urine leakage, etc. over a 24-hour period. It’s important for you to complete this 24-hour diary and bring it to your first visit. That way, we’ll have information that we need to best evaluate and treat any problems you may have. If you have any trouble with the forms or the diary, please call us before your appointment. We want to help you get the most out of your visit.

Download the new patient form here. 

 

24-Hour Voiding Diary

We may request that you complete this 24-hour voiding diary during the course of your ongoing care.

Download the 24-hour voiding diary here. 

 

Surgical Form

For our patients who are planning a surgical procedure:

Download the post-operative restrictions form here.