If your child has a problem with wetting his pants during the day, please collect the following information for several instances of wetting before you call your child's healthcare provider to make an initial or follow-up appointment. This information may be very helpful to your provider in reaching a correct diagnosis.
Date:
Time of day:
Place (home, school, etc.):
People present:
How much? (1 = small spot on underwear, 5 = complete):
Who recognized it (you or your child)?
Activity at time of wetting:
Was your child holding back urine before the wetting?
Was your child upset or angry before the wetting?
Was your child laughing?
Did the wetting occur while your child was on the way to the toilet?
If so, how much of the urine got into the toilet?
What do you think caused the wetting this time?
