This Questionnaire contains public sector information licensed under the Open Government Licence v3.0
What does this Questionnaire do?
An Accurx Questionnaire allows you to send questionnaires out to patients to gather data. The UTI Questionnaire (partnered - TARGET) is used to help gather data that would be useful to monitor a patient’s symptoms. This article details what the patient will see in the text, and what gets written to the record for their responses.
💬 Enrolment SMS:
Once the patient has accessed the link, they will be prompted to enter their date of birth in order to access the questionnaire 📆
Questions:
1. Do you have any of the following symptoms?
Choose all that apply (you can select none)
Discomfort or pain passing urine
Passing urine more frequently at night
Urine that is more cloudy
New discharge from the vagina
New discharge from the penis
2. Do you have any of the following symptoms?
Choose all that apply (you can select none)
Passing urine more frequently during the day
Feeling a sudden urgency to pass urine
Urine has visible blood in it
Feeling more confused
Discomfort or pain in the tummy
3. Do you have any of the following symptoms?
Choose all that apply (you can select none)
New pain in lower back
Nausea
Vomiting
Fever
Shivering
Other symptoms
(If ‘Other symptoms’ is selected)
4. What other symptoms do you have?
Type answer here
5. How long have you had these symptoms?
Less than 3 days
3 days - 1 week
1 - 2 weeks
More than 2 weeks
6. What have you done to manage your symptoms?
Choose all that apply (you can select none)
Painkillers e.g. paracetamol
Antibiotics
Cranberry products
Drinking more fluids
Other remedies
(If ‘Other symptoms’ is selected)
7. What other remedies have you tried?
Type answer here
8. Have you had a urinary tract infection before?
These are sometimes called bladder or water infection
Yes - in the previous 6 months
Yes - in the previous year
Yes - in the previous 3 years
Yes - more than 3 years ago
No
9. Is there a possibility you might be pregnant?
Yes
No
10. Do you have a urinary catheter?
This is a tube that is inserted into your bladder which is used to empty the bladder and collect urine
Yes
No
When they have submitted their answers they will be thanked for completing the survey and sent a confirmation SMS 👇
Response in the Accurx Desktop toolbar: UTI Team 👇
Please then select the save to record button if you wish for these results to be saved to the patient's medical record 📚
If you still have any questions or concerns, feel free to chat with us using the green message bubble in the bottom right-hand corner of this page. 👉