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PSA test request

PSA Test Request

Why are you requesting a PSA test today?

Reason for requesting a PSA check:

Family History

Family history of prostate cancer:
Family history of breast cancer:
Family history of ovarian cancer:

Symptoms experienced

Do you suddenly feel the need to pee?
Do you frequently feel the need to pee?
When you pee, do you have a weak stream of urine?
When you pee, do you feel like you can’t empty your bladder?