At least one in four Americans suffers from incontinence. It’s not just a medical concern, it’s a problem that impacts one’s emotional, social and psychological life.

If it’s a concern for you, take a few minutes to complete this questionnaire.


Which of these symptoms best describes you? Select all that apply.

Frequent, strong or sudden urination-day, night, or both

Accidental leakage with physical activity-exercising, sneezing, or coughing

Leakage with little or no warning-sometimes unable to make it to the bathroom in time

Unable to completely empty bladder-feels like there is more even after going to the bathroom

Pain in bladder or pelvic area

Problems with bowel function (if checked, please select symptom from these three:

Accidental loss or leakage of stool     Constipation     Other

No bladder of bowel problems (if checked, please conclude questionnaire)

These symptoms are bothersome and I would like to learn more about potential treatment options from a FirstLight Health System specialist



It’s possible to put an end to the worrying.
Treatment options are available.
Learn more today.
Call FirstLight at 800-245-5671


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