Professional Documents
Culture Documents
Medical history
Physical examination
Asking about sleep patterns, bowel
habits and urinary symptoms
Discussing any stressful situations
contributing to the problem
Urinalysis and urine culture
Sleep studies
RREEFFEERRRRAALL FFO
ORRM
M
Youthdale Child and Adolescent Sleep Centre
227 Victoria Street, Lower Level 2
Toronto, Ontario, M5B 1T8
Phone: (416) 703-0505 Fax: (416) 703-0507
Behavioral Management in
treatment of Nocturnal
Enuresis
1)
2)
3)
4)
5)
6)
Patient Information:
Name:
DOB:
Contact Phone #:
Age:
Height:
Referring Dentist / Doctor:
Name:
Address:
Phone #:
Fax #:
Male
. Weight:
Female
.
.
.
.
.
.
.
.