Urogynecology New Patient Form
What a urogynecology new patient form asks, with sample questions on bladder, bowel, pregnancy, and surgical history.
A urogynecology new patient form records the visit reason, bladder and bowel habits, pregnancy and surgical history, and mobility before a first urogynecology visit. It's also called a urogyn new patient questionnaire.
Urogynecology new patient form, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on a urogynecology new patient form in the patient's own language, strictly following the practice's instructions.
- Intake before the visit. Patients answer online before they arrive, or at a kiosk when they check in.
- Answers ready for the clinician. Clinicians see what the patient said before the visit starts.
- Less workload at the front desk. Staff spend less time handing out forms and entering answers by hand.
- Key details at a glance. The care team sees what matters up front and decides who needs attention first.
The form becomes a natural conversation: patients answer by talking, in their own words. AI Doctor is an information and patient-assistance interface. It collects answers for the care team to review. It doesn't diagnose, triage, or give treatment advice.
Sample urogynecology new patient form questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- Why are you coming for this evaluation?Visit reason
- How long have you had this problem?Visit reason
- How often do you wake at night to urinate?Bladder
- Do you wear pads for urine leakage?Bladder
- How often do you have bowel movements?Bowel
- Do you have chronic constipation?Bowel
- How many vaginal deliveries have you had?Obstetric history
- Was forceps or vacuum used at a delivery?Obstetric history
- Have you had a hysterectomy, and what type?Surgical history
- Did you have complications after any surgery?Surgical history
- What is your usual level of physical activity?Daily life
- Do you use a cane, walker, or wheelchair?Daily life
These are examples to read, not a form to fill in.
Urogynecology new patient form: FAQ
What does a urogynecology new patient form ask?
The sample questions on this page are based on the urogynecology new patient forms of Weill Cornell Medicine and the University of Rochester Medical Center. This page groups them into six areas: visit reason, bladder, bowel, obstetric history, surgical history, and daily life.
Who fills in a urogynecology new patient form, and when?
The patient, before the visit. The University of Rochester form starts with why the patient is coming, how long the problem has lasted, and what treatments were tried.
Does it include standardized questionnaires?
The Weill Cornell packet adds standardized questionnaires on pelvic floor symptoms after the history pages. This page does not reproduce them.
Is a urogynecology new patient form the same as a prolapse questionnaire?
Not quite. Prolapse symptoms are one part; the Weill Cornell and University of Rochester forms also cover bladder, bowel, pregnancy, and surgical history.
Does it ask about mobility?
Yes. The University of Rochester form asks whether the patient walks without help, uses a cane, walker, or wheelchair, or needs help onto an exam table.
What happens after the form is completed?
The practice's team reviews the answers before the visit. Weill Cornell's form says it will be added to the medical record.
Does AI Doctor give medical advice?
No. It collects information for the care team. It doesn't diagnose, triage, or recommend treatment.
Can patient answers stay on our own servers?
Yes. RAVATAR offers on-prem deployment: the platform can run inside your own perimeter, so patient answers stay there. RAVATAR complies with GDPR and the EU AI Act.
Set up your AI Doctor in Genesis AI Avatar Studio
Genesis AI Avatar Studio is where you set up, test, and publish AI avatars for your website, mobile app, or Holobox. No coding or technical skills needed.
- 01Choose the AI Doctor avatar.
- 02Add your practice's FAQs and visit information.
- 03Talk to it, then publish it.
