Contact Us

Ask A Question
Describe Your Situation or
Request A Consultation

Call (305) 539-3795 (305) 504-8667 or fill out the short form below. We will usually respond within 1 business day and often the same day. Don't hesitate your questions are welcome!

Full Name

Phone

Question, Situation or Request

We respect your privacy. The information you provide will be used to answer your question. Or to schedule an appointment if required.

Questionnaire

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

Not at all (0 points)

Less than 1 time in 5 (1 points)

Less than half the time (2 points)

About half the time (3 points)

More than half the time (4 points)

Almost always (5 points)

Over the past month, how often have you had to urinate again less than 2 hours after you finished urinating?

Not at all (0 points)

Less than 1 time in 5 (1 points)

Less than half the time (2 points)

About half the time (3 points)

More than half the time (4 points)

Almost always (5 points)

Over the past month, how often have you found you stopped and started again several times when you urinated?

Not at all (0 points)

Less than 1 time in 5 (1 points)

Less than half the time (2 points)

About half the time (3 points)

More than half the time (4 points)

Almost always (5 points)

Over the past month, how often have you found it difficult to postpone urination?

Not at all (0 points)

Less than 1 time in 5 (1 points)

Less than half the time (2 points)

About half the time (3 points)

More than half the time (4 points)

Almost always (5 points)

Over the past month, how often have you had a weak urinary stream?

Not at all (0 points)

Less than 1 time in 5 (1 points)

Less than half the time (2 points)

About half the time (3 points)

More than half the time (4 points)

Almost always (5 points)

Over the past month, how often have you had to push or strain to begin urination?

Not at all (0 points)

Less than 1 time in 5 (1 points)

Less than half the time (2 points)

About half the time (3 points)

More than half the time (4 points)

Almost always (5 points)

Total Criteria Point Count

<!--

IPSS: Score

-->

0 to 7 points: Mild symptoms

8 to 18 points: Moderate symptoms

20 to 35 points: Severe symptoms

Full Name

Phone/Mobile

Questionnaire issues-treatments

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

Not at all (0 points)

Less than 1 time in 5 (1 points)

Less than half the time (2 points)

About half the time (3 points)

More than half the time (4 points)

Almost always (5 points)

Over the past month, how often have you had to urinate again less than 2 hours after you finished urinating?

Not at all (0 points)

Less than 1 time in 5 (1 points)

Less than half the time (2 points)

About half the time (3 points)

More than half the time (4 points)

Almost always (5 points)

Over the past month, how often have you found you stopped and started again several times when you urinated?

Not at all (0 points)

Less than 1 time in 5 (1 points)

Less than half the time (2 points)

About half the time (3 points)

More than half the time (4 points)

Almost always (5 points)

Over the past month, how often have you found it difficult to postpone urination?

Not at all (0 points)

Less than 1 time in 5 (1 points)

Less than half the time (2 points)

About half the time (3 points)

More than half the time (4 points)

Almost always (5 points)

Over the past month, how often have you had a weak urinary stream?

Not at all (0 points)

Less than 1 time in 5 (1 points)

Less than half the time (2 points)

About half the time (3 points)

More than half the time (4 points)

Almost always (5 points)

Over the past month, how often have you had to push or strain to begin urination?

Not at all (0 points)

Less than 1 time in 5 (1 points)

Less than half the time (2 points)

About half the time (3 points)

More than half the time (4 points)

Almost always (5 points)

Over the past 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?

Not at all (0 points)

Less than 1 time in 5 (1 points)

Less than half the time (2 points)

About half the time (3 points)

More than half the time (4 points)

Almost always (5 points)

Total Criteria Point Count

IPSS: Score

0 to 7 points: Mild symptoms

8 to 18 points: Moderate symptoms

20 to 35 points: Severe symptoms

First Name

Last Name

Phone/Mobile

PPC Form

First Name

Phone

Question, Situation or Request

Name (required)

Email (required)

Message:

Full Name (required)

Phone (required)

Your Email (required)

Your Question, Comment or Request:

All Forms

Contact Us

Ask A Question
Describe Your Situation or
Request A Consultation

Questionnaire

IPSS: Score

Questionnaire issues-treatments

IPSS: Score

PPC Form

A Personal Touch

Aventura North Miami Clinic

Vivid Vascular

Kendall / South Miami Clinic

Vivid Vascular

All Forms

Contact Us

Ask A Question Describe Your Situation or Request A Consultation

Questionnaire

IPSS: Score

Questionnaire issues-treatments

IPSS: Score

PPC Form

A Personal Touch

Aventura North Miami Clinic

Vivid Vascular

Kendall / South Miami Clinic

Vivid Vascular

Ask A Question
Describe Your Situation or
Request A Consultation