Victoria, BC

Victoria Gynecology & Continence Clinic

Forms

*Please note that unless encrypted, email messages sent via the internet may not be secure and could be intercepted and read by someone else. Please bear this in mind when deciding whether to include personal or sensitive information in any email messages you intend to send. The office of Dr. David Quinlan accepts no responsibility for any information submitted that fails to reach its intended recipient. If you are concerned about sending information online, then please use the printable PDF forms.

Patient In-Take Form

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


Pelvic Floor Questionnaire

Click below to access the Pelvic Floor Questionnaire.
Printable PDF | Online Form


Urinary Incontinence - Quality of Life Questionnaire

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


Urinary Incontinence - Severity Score Questionnaire

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


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 | Online Form