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Our Office

Patient Forms

Before your appointment with us, quickly and conveniently access patient forms from our practice.

Download Patient Forms

To view the forms listed below, you will need Adobe Reader. You may download Adobe Reader for free at Please bring your completed forms with you to our office at the time of your visit.

Office Policies

What to Bring to Your Appointment:

  • Your insurance card
  • Physicians referral forms if required by insurance
  • Pertinent information about your medical and surgical history>
  • Any recent x-rays or appropriate records you may have>
  • A list of current prescription, over-the-counter, or herbal medications >you are taking, including dose and frequency>


All visits should be made with appointments during normal business hours. Walk-in patients are accepted only in cases of emergency. See office hours for detail.

After Hours & Emergency Care

We provide 24 Hour emergency service 7 day/week.  If your condition is not an emergency, please contact us during normal business hours or make an appointment for regular concerns.

Prescription Renewals

We will typically give several refills on chronic use of prescriptions until next appointed time.If you can not come to your scheduled office hours, we will typically renew prescriptions directly for a short time until you can return to the office for interval history and physical examination.  


Physicians at the Urological Institute accept Medicare and most insurance plans. We provide insurance billing for insurance plans we accept. Anything not covered by insurance will be your responsibility.We request payment at the time of your appointment for services that are not covered by insurance. Your insurance company may also require you to pay a co-payment at the time of your appointment.You are responsible for payment of the co-pay before any services are rendered.If there is a deductible on your insurance policy, you are responsible to make prompt payment if our office is not reimbursed for services rendered.

When necessary, our staff will work closely with patients who require a payment plan.

We accept major credit cards for payment (Visa/MasterCard). We will automatically bill your insurance carrier for you, and each month you will receive a statement outlining the activity on your account if it is active. Our fees are reasonable and are typically near the 50th percentile for the United States. Please address any questions concerning specific fees prior to any procedure or testing that you may undergo. Questions concerning billing, accepted insurances or professional fees should be addressed to our Accounts Manager during office hours. Questions regarding your plan’s coverage and benefits should be directed to your employer or insurance company.

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