For each item, please check the box next to the statement that best reflects your current situation. Please read the text carefully and only check one box in each section. 66.Bowel management A. Do you need assistance with bowel management? e.g., for applying suppositories Yes No B. My bowel movements are ... irregular or seldom (less than once in 3 days) regular (once in 3 days or more) C. Fecal incontinence (“accidents”) happens ... daily 1-6 times per week 1-4 times every month less than once per month never 66/126
