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24 hour pad weight record

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Complete only if you wear any sort of pad because of urinary leakage

Instructions
  • Weigh 1 pad when dry and document weight
  • Over the next 24hr period keep all used pads in a plastic bag
  • At the end of the 24hr period weigh all your used pads together
  • Record this cumulative weight below. Discard pads.

Patient Details

Name*
DD slash MM slash YYYY

Pad Weight Record