Suspected urinary tract infection questionnaire

What new symptoms are you experiencing?
Please select all those which apply.
Which temperature symptoms?

Further Information

E.g. Number of cups per day
Do you have a previous history of urinary tract infections?
Have you had an infection in the last 4 weeks?
Are you (or could you be) pregnant?
Do you have a urinary catheter?
E.g. Painkillers, antibiotics, cranberry products, drink more liquids etc.