Thank you for your interest in participating in clinical trials at UAB Medicine. Please use this secure form to answer each question below about urogynecology conditions you suffer from.

For additional assistance with your urogynecology condition, please leave us a message at 205.934.5498 . A representative from our office will contact you as soon as possible. Or you can email us at urogynecology@uabmc.edu .

For more information about our research studies, click here.

Have you had accidental bowel leakage (loss of liquid or solid stool over the past 3 months that is bothersome enough that you want treatment?
Do you usually have a bulge or something falling out that you can see or feel in your vagina.
Do you leak urine with a strong sense of urgency that is bothersome? (Ex: Leak on the way to the bathroom or while putting your key in the door)
Do you leak urine with physical activity such as coughing, sneezing, laughing or walking that is bothersome?
Full Name
Address
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Date of Birth
How did you hear about this study?
May we contact you in the future for other studies you may be eligible for participation?

If you would like to learn more about our urogynecology services, please visit our Pelvic Floor and Urogynecology Disorders page by Clicking Here »