HOSFU

Three-day bladder diary

Record your usual routine, including overnight events. Mark missing measurements instead of guessing. This sheet is a discussion aid, not a diagnosis.

Day 1 / Date: ____________

Bedtime: ________ Final wake: ________

Time	Drink and amount	Urine amount	Urge or leak	Activity or notes

Questions for your appointment: ______________________________________________

Day 2 / Date: ____________

Bedtime: ________ Final wake: ________

Time	Drink and amount	Urine amount	Urge or leak	Activity or notes

Questions for your appointment: ______________________________________________

Day 3 / Date: ____________

Bedtime: ________ Final wake: ________

Time	Drink and amount	Urine amount	Urge or leak	Activity or notes

Questions for your appointment: ______________________________________________