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Background: Constipation is common in the adult population, and pelvic floor physical therapy is a first line treatment. Constipation is frequently associated with multiple other urogenital symptoms such as urinary incontinence, dyspareunia, and overactive bladder. Biofeedback interventions are successful treatment options for functional constipation; however, adherence to pelvic floor physical therapy is low. There are multiple methods used to increase adherence and one method is the development of therapeutic concordance. Therapeutic concordance is a mutual agreement between patient and clinician regarding treatment. The purpose of this case report is to highlight the influence of therapeutic concordance on the rehabilitation management of a patient with chronic constipation and multiple urogenital symptoms. Case Description: The patient was a 53-year-old female with chronic idiopathic constipation and a reported history of urinary incontinence and dyspareunia. The patient presented with pelvic floor stiffness, pelvic floor incoordination, and a nonrelaxing pelvic floor. Intervention: The patient was seen for one total treatment. Treatment was aimed at developing therapeutic concordance through education and shared decision making. Treatment consisted of relaxation techniques for the pelvic floor while improving neuromuscular control. The goal was to utilize biofeedback and intravaginal manual therapy in future sessions. Outcome Measures: The patient’s outcomes were limited by minimal physical therapy sessions. The patient canceled her second appointment with reports of worsening symptoms and canceled her third appointment with no follow-up. Discussion: The purpose of this case report was to highlight the influence that therapeutic concordance has on the treatment of a patient with chronic constipation. In this case, the patient was unwilling to adhere to the shared decision-making plan that led to cancelation of treatment and the inability to utilize the gold standard treatment for functional constipation.