Have this calendar with you when you call the clinic and when you come to your next visit.
List all fecal soiling accidents. If there is room, record the laxative dose given each day. . Record all stools for one month. Include the size (large, medium, small), and the consistency of the stool (use the scale on the back of this sheet)
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Draft Number: 2142Revision: October 21, 2025
This content was created to help you care for your child and/or family member. It does not take the place of medical care. Talk with your healthcare provider for diagnosis, treatment and follow-up.