Restoring Pelvic Support. Curing Incontinence.

Home

About Our Practice

What We Treat

Dr. Heather van Raalte

Alison Cooke, LPN

Letters from Africa

Patient Education

Pelvic Organ Prolapse

Urogyn ABC's

Your Visit

Initial Appointment

Urodynamic Testing

Directions

Resources

For Physicians

IFPM

Appointments

 

On your first visit to our office, we will carefully review your medical history, do a pelvic exam, take a urine sample for analysis, and do a preliminary test called uroflowmetry. Our physician will talk with you about her findings, and we will schedule further tests if necessary.

You should complete the following forms prior to your first visit, including a bladder record that must be recorded for two 24-hour periods. These forms will help our physician to better assess your condition; and henceforth recommend a treatment plan specific to your individual concerns. This information is very important. Please take the time to carefully complete them to the best of your ability. If you have problems downloading these forms, please call (609) 924-2230 to have the forms mailed to you.  

             ♦    Urogynecology Questionnaire

              ♦     Sexual Function Questionnaire

              ♦     Patient Demographic Form

              ♦     Bladder Diary

              ♦     Patient Medical History Form 


Patient Medical History Form