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Wetting Diary (Daytime)

Thumbnail image of: Wetting Diary Form

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.

Time and Place

Date:

Time of day:

Place (home, school, etc.):

People present:

Description of Wetting

How much? (1 = small spot on underwear, 5 = complete):

Who recognized it (you or your child)?

Triggers for Wetting

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?

Use of the Toilet

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?

Your Observations

What do you think caused the wetting this time?


Written by Barton D. Schmitt, MD, author of “My Child Is Sick”, American Academy of Pediatrics Books.
Pediatric Advisor 2012.1 published by RelayHealth.
Last modified: 2009-08-13
Last reviewed: 2010-06-02
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2012 RelayHealth and/or its affiliates. All rights reserved.

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