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Bedwetting > Bedwetting tools and resources > Bedwetting diagnostic quiz
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Bedwetting diagnostic quiz

The Bedwetting Diagnostic Quiz is an aid to help speed up the process of assessing your child's condition. Before visiting your doctor, take a few moments to print this page and answer the included questions. Take it with you to your child's next appointment.

  1. Your child's name

    ____________________________

    Age

    ____________________________

    Sex

    ____________________________

    Weight

    ____________________________

    Height

    ____________________________

  2. How long have you considered bedwetting a problem (answer in months)

    ____________________________

  3. Does your child have any of the following symptoms:
     Cloudy urine
     Frequent trips to the bathroom
     Burning feeling on urination
     Other

  4. Have there been other bedwetters in the family? Check all that apply:
     Brothers/sisters
     Parents
     Uncles/aunts
     Cousins

  5. Has your child ever been diagnosed as having a urinary tract infection?
     Yes      No

  6. How many times a week does your child wet the bed?

    ____________________________

  7. How many hours does your child sleep before wetting the bed?
     2-3
     4-5
     6-7
     8-9
     Over 9
     Don't know

  8. Does your child wet his or her clothes during the day?
     No
     Rarely
     Occasionally
     Often
     Daily

  9. Do you do any of these things now to help treat the problem?
     Limit fluids
     Wake child up
     Punish failure
     Reward success
     Other (please specify)

    ____________________________

  10. Is your child ever teased, bullied, or humiliated for being a bedwetter?
     Yes      No      Don't know

  11. Has your family, or your child, had to miss any of these activities because of bedwetting?
     Sleeping out
     Sleepover visits
     Family vacation trips
     Class trips
     Summer camp

  12. From your child's point of view, please check all the reasons he or she wants to overcome bedwetting. Please circle the most important.
     Build self-esteem
     Feel more confident
     Avoid humiliation
     Share family experiences
     Be equal with other children
     Go to camp or sleepovers
     Be able to share a bed with their siblings
     Other




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