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PELVIC FLOOR WORKSHEET NAMEDateTimer Initial Visit am/PMR Discharge VisitCONDITION (CHECK ALL THAT APPLY)(A) Bladder incontinence (B) Urinary urgency/frequency(C) Bowel incontinence (D) Fecal urgency(E)
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Pelvic floor worksheet is a document used to track and record information related to pelvic floor exercises and therapy.
Individuals undergoing pelvic floor therapy or exercises are required to file pelvic floor worksheet.
Pelvic floor worksheet can be filled out by recording details of exercises, repetitions, duration, and any notes regarding the therapy sessions.
The purpose of pelvic floor worksheet is to monitor progress, track improvements, and provide a reference for healthcare providers.
Information such as type of exercises, sets, reps, duration, intensity, any discomfort or pain experienced, and any modifications made must be reported on pelvic floor worksheet.
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