Evaluation Form

The diagnosis form is suitable for bedwetters ages 4-20. If the individual is older than 20 or if he or she suffers from medical, psychological or other issues that you feel affect the bedwetting issue, please use the “Contact us” form and elaborate about the bedwetting condition.

Please fill out the assessment form and Dr. Sagie will personally evaluate your child’s bedwetting condition.

Disclosure: By clicking send you agree to give your email address to Dr. Sagie’s Bedwetting Clinics for the purpose of receiving an email with your child’s evaluation including updates about bedwetting. You can choose to stop receiving these emails at any time.