Victoria, BC

Victoria Gynecology & Continence Clinic

Forms

Patient In-Take Form

New patients, please complete the Patient In-Take Form prior to your first visit to the office.


Pelvic Floor Questionnaire

Click here to access the Pelvic Floor Questionnaire.


Urinary Incontinence - Quality of Life Questionnaire

Click here to access the Urinary Incontinence - Quality of Life Questionnaire


Urinary Incontinence - Severity Score Questionnaire

Click here to access the Urinary Incontinence - Severity Score Questionnaire


Urodynamic Information Sheet

Click here to view the Urodynamic Information Sheet


Provide Feedback

Complete our confidential Feedback Form to let us know how we're doing.