BPH Survey

BPH (Benign Prostatic Hyperplasia) Treatment Survey

Please complete the 30 second survey below!

We are conveniently located in East Mesa AZ.

Over the last month, how often have you had a sensation of not emptying your bladder completely after you finished urinating? *

Not at all

Less than 1 time in 5

Less than half the time

About half the time

More than half the time

Almost always

During the last month, how often have you had to urinate again less than 2 hours after you finished urinating? *

Not at all

Less than 1 time in 5

Less than half the time

About half the time

More than half the time

Almost always

During the last month, how often have you found you stopped and started again several times when you urinated? *

Not at all

Less than 1 time in 5

Less than half the time

About half the time

More than half the time

Almost always

During the last month, how often have you had a weak urinary stream? *

Not at all

Less than 1 time in 5

Less than half the time

About half the time

More than half the time

Almost always

During the last month, how many times did you most typically get up to urinate from the time you went to bed at night until the time you got up in the morning? *

None

One time

Two times

Three times

Four times

Five or more times

If you were to spend the rest of your life with your urinary condition the way it is now, how would you feel about that? *

Delighted

Pleased

Mostly satisfied

Mixed

Mostly dissatisfied

Unhappy

Terrible

Please Fill Out Your Contact Information Below & Click Submit.

Someone from our staff will be in contact with you to answer all your questions & concerns regarding your BPH treatment.

First Name *

Last Name *

Email *

Phone *

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