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Urine Frequency / Volume / Leaks Chart

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This form is to: 1) Record the times you pass urine. 2) Record the amount of urine you pass on each occasion. 3) Record the times you leak urine (are incontinent). So...

  • Please tick (to the nearest hour) each time you go to the toilet to pass urine.
  • If your doctor or nurse asks, when possible, also record the amount (volume) of urine you pass each time. You can use a household measuring jug to do this. If you are away from home and it is inconvenient to measure the amount then just record the time with a tick.
  • If you leak urine unintentionally, record the times it happens (to the nearest hour). Put one, two or three + signs in the box. + = damp. ++ = wet. +++ = soaking.

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Related pages in Patient UK

Your Experience (^ top of page)

 Please add your experience about this condition / medicine
 View Patient Experience for 'Incontinence Of Urine' (1 there)
 Incontinence - Picture Summary
 Overactive Bladder Syndrome
 Pelvic Floor Exercises
 Stress Incontinence
 Urge Incontinence
 Urinary Incontinence

Support Group Allanda Ltd
Support Group Bladder and Bowel Foundation
Support Group Dry-For-Life
Support Group ERIC - Education & Resources for Improving Childhood Continence
Support Group PromoCon
Support Group Robinson Healthcare Ltd
Support Group SnugNights
Support Group Women's Health Concern

 Barthel's Index of Activities of Daily Living
 Lower Urinary Tract Symptoms (LUTS) in Women
 Neurogenic Bladder
 Urinary Incontinence

 Guidelines on Incontinence Of Urine
 Guidelines on Stress Incontinence

 Links to online videos on Incontinence Of Urine
 Links to online videos on Stress Incontinence
 Light Adult Incontinence (video page)

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All news by related topic

 Incontinence Of Urine news
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Online Pharmacy

 Aquaflex Pelvic Floor Exercise System

Medical equipment

 Pelvic Floor Toners / Exercisers

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Books

 Female Urinary Incontinence (Understanding)
 Incontinence in Women : British Medical Association's Family Doctor Series
 Urinary Incontinence : British Medical Association's Family Doctor Series

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