SYMPTOMS REGISTRATION

1. Have you noticed dribbling of urine?

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2. Do you feel urgency to go to the toilet?

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3. Have you noticed that you pass urine with reduced force?

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4. Have you suffered from urinary tract infections?

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SYMPTOMS REGISTRATION
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Personal Health History

Any current health condition diagnosis?

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Any past health condition?

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Any past hospitalisations/surgeries?

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Have you ever taken any antibiotics?

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Have you ever taken birth control?

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Have you ever been on hormone replacement therapy?

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