Help Us Find Experts

Has a physician, nurse or physical therapist made a difference in your continence care? Help us create a database of healthcare providers who are experts in the area of bladder and bowel health. Submit your medical expert’s name, title, email address, phone number and mailing address using this form. We’ll contact the healthcare provider to get their permission before adding them to the database. The more information you can provide, the easier it will be for us to contact your expert.

Your First Name*


Your Last Name*


Your E-mail Address*


Health Care Providers First Name*


Health Care Providers Last Name*


Health Care Providers E-mail Address


Health Care Providers Phone Number*


Health Care Providers Practice Address*


Health Care Providers City*


Health Care Providers State*


Health Care Providers Zip Code*


By hitting “submit” you will be taken to a confirmation page on www.nafc.org.