Pediatric Pelvic Floor Provider Pack

Pediatric Pelvic Floor Provider Pack

This packet includes everything you need to get started or elevate your treatment of pediatric pelvic floor dysfunction.

Inside the packet you will find editable documents that you can customize for your business with your heading and logos including:

Pre-Evaluation Intake Form

Consent to Treat Form

Homework Chart Template

Evaluation Questions and Flow Guide

Safety Contract for Treatment Form

Neuromuscular Stimulation Unit for Home Use

Abdominal Electrical Stimulation for Bowel Motility Instructions

Perianal Electrical Stimulation for Sensation, Strength & Coordination Instructions

Bowel & Bladder Diary/Log

Investigation for Dry Nights Chart & Instructions

Dry Nights Progress Tracking Chart & Instructions