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Bladder Retraining Form Mobile App

The Bladder Retraining Form mobile app offers a simple way to track the progress of bladder retaining patents based on various criteria. Designed for conditions resulting in urinary incontinence, overactive bladder and pelvic floor conditions, the bladder muscle retraining app makes it easy to assess bladder problems using a smartphone or tablet.

The questions in the app are related to several different areas, including the ability to pass urine, number of times the patient has urinated, urine leakage and more. Once completed, the physicians can sign off on the results and save them to the patient's medical records.

Want more interdisciplinary discharge apps? Visit our interdisciplinary discharge apps category page!

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Take a peek inside the Bladder Retraining Form Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    Name

  • Ico textbox

    Title

  • Ico date

    Date

  • Ico statictext

    Applicant Information

  • Ico textbox

    Client Name

  • Ico textbox

    Address

  • Ico textbox

    City

  • Ico textbox

    Province

  • Ico textbox

    Postal Code

  • Ico textbox

    Home Phone

  • Ico textbox

    Other Phone

  • Ico date

    Date of Birth

  • Ico textbox

    Health Card Number

  • Ico dropdown

    Gender

  • Ico statictext

    Emergency Contact Information

  • Ico textbox

    Emergency Contact Name

  • Ico textbox

    Emergency Contact Phone

  • Ico textbox

    Primary Physician Name

  • Ico textbox

    Primary Physician Phone

  • Ico date

    Date of Admission

  • Ico date

    Current Date

  • Ico dropdown

    Admission Period

  • Ico integer

    Is the patient continent of unirine when OBB?

  • Ico integer

    Is this resident continent of urine when in bed?

  • Ico integer

    Is this resident incontinent of urine 24 hours each day?

  • Ico integer

    Will resident's general state of health enable him/her to participate in a bladder retraining pro...

  • Ico integer

    Can the resident understand what will be expected of him/her when on a bladder retraining program?

  • Ico integer

    Does resident have urinary history or diagnosis which may prevent him/her from regaining bladder ...

  • ...and More!

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