ARFP

Autumn Road Family Practice

904 Autumn Road, #200

Little Rock, AR 72211

Overactive Bladder-Validated 8-question Awareness Tool

These questions ask about how bothered ypu may be by some bladder symptoms. Some people are bothered by bladder symptoms and may not be aware that there are treatments available for their symptoms. Please mark the answer that best decribes how much you are bothered by each symptom.

How bothered have you been by:

1. Frequent urination during the daytime hours?
2. An uncomfortable urge to urinate?
3. A sudden urge to urinate with little or no warning?
4. Accidental loss of small amounts of urine?
5. Nightime urination?
6. Waking up at night because you had to urinate?
7. An uncontrollable urge to urinate?
8. Urine loss associated with a strong desire to urinate?
Please mark your gender: