Victoria, BC

Victoria Gynecology & Continence Clinic

Forms

Please download and print the PDF form required for your visit and complete it prior to coming for your appointment.

Patient In-Take Form

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


Pelvic Floor Questionnaire

Click below to access the Pelvic Floor Questionnaire.
Printable PDF


Urinary Incontinence - Quality of Life Questionnaire

Click below to access the Urinary Incontinence - Quality of Life Questionnaire.
Printable PDF


Urinary Incontinence - Severity Score Questionnaire

Click below to access the Urinary Incontinence - Severity Score Questionnaire.
Printable PDF


Urodynamic Information Sheet

Click below to view the Urodynamic Information Sheet.
Printable PDF


Provide Feedback

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