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Thank you for choosing Advanced Urology for your urologic care. Below you will find some forms that we request you fill out prior to your appointment. This includes the history sheet of all medical conditions past and present. Please be sure to include all medications and doses that you are taking. If you have any questions, please call one of our office locations and we will be happy to assist you.

Patient Forms:

You can download, print and complete the necessary forms using the links below. Please bring your completed forms to your appointment.

• New Patient Information Form (PDF)
• Patient History Form (PDF)
• Medications List Form (PDF)

[The above forms are in PDF format. If you have problems downloading or printing the forms, please consult our PDF Help page.]

Our Notice of Privacy Practices describes how information about you may be used and disclosed. New patients will be asked to sign an Acknowledgement of Receipt of Notice of Privacy Practices.

Preparing for Your Appointment:

• Be sure to bring all insurance cards and a picture ID.
• You will be asked to fill out a few forms in the office - prior to your appointment.
• Insurance co-payments will be collected when you arrive. We accept cash and all major credit cards.
• Be prepared to provide a urine specimen during your appointment.
• Please arrive 10 minutes prior to your scheduled appointment time.

Parking:

Parking is located in the medical buildings - rates are posted at the entrance. We do not validate parking. Pharmacies in the building do validate parking with a purchase. Parking is also available on the streets, but please be aware that street signs are enforced.

Disability Claims:

There is a charge of $10 for each separate state and private disability form. Please allow four working days for the insurance forms to be completed.

Thank you for your assistance and cooperation. We look forward to seeing you.