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INSTRUCTIONS: CHECK ALL THAT APPLY
I sometimes have pelvic pain (in genitals, perineum, pubic or bladder area, or pain with urination) that exceeds a ‘3’ on a 1-10 pain scale, with 10 being the worst pain imaginable
I can remember falling onto my tailbone, lower back, or buttocks (even in childhood)
I sometimes experience one or more of the following urinary symptoms
Accidental loss of urine
Feeling unable to completely empty my bladder
Having to void within a few minutes of a previous void
Pain or burning with urination
Difficulty starting or frequent stopping/starting of urine stream
I often or occasionally have to get up to urinate two or more times at night
I sometimes have a feeling of increased pelvic pressure or the sensation of my pelvic organs slipping down or falling out
I have a history of pain in my low back, hip, groin, or tailbone or have had sciatica
I sometimes experience one or more of the following bowel symptoms
Loss of bowel control
Feeling unable to completely empty my bowels
Straining or pain with a bowel movement
Difficulty initiating a bowel movement
I sometimes experience pain or discomfort with sexual activity or intercourse
Sexual activity increases one or more of my other symptoms
Prolonged sitting increases my symptoms
IF YOU CHECKED 3 OR MORE, PELVIC FLOOR DYSFUNCTION IS LIKELY. YOU MAY BENEFIT FROM AN ASSESSMENT FROM A PELVIC FLOOR PHYSICAL THERAPIST.
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Home
About Us
Our Story
Green Mission
Wellness Space
Apply Now
Medical Insurance
Gallery
Services
Current Specials
Massage Therapy
Facials
Body Care
Acupuncture
Lashes & Brows
Hair Removal
Couples Services
Pre-Natal Care
Oncology Services
Athletes Services
Pricelist
Coaching and Mentoring
Wellness Packages
Products
Gift Certificates
Gift Certificates
Gift Certificate Terms & Conditions
Workshop & Events
Wellness Blog
Contact