New Patients

For all new patients please print these five documents and fill them out completely and bring them to your first appointment. This will save you time at your appointment.

Office Policies

Our urology practice offers an outstanding combination of experienced physicians who are skilled in the care of urologic cancers, laparoscopic and robotic assisted surgery, urinary stones, urinary incontinence, pediatric urology and other aspects of urologic care. Our office policies are below.

Insurance and Patient Payment Policy

  • As a courtesy service, all primary insurances will be filed with proper insurance identification. Patients are responsible for payment of copays at the time of each office visit.
  • Managed care patients are responsible for obtaining referrals prior to seeing the physician. Patients should be aware of how many visits have been authorized by their primary care physician on each referral. Should a referral not be obtained, the patient is considered to be self-pay and will be charged for the appropriate level of service provided.
  • For all insurances, patients will be responsible for payment of the deductible (or percentage of patient responsibility) at the time of visit
  • Patients without insurance will be responsible for payment in full when a service is provided.
  • Payment methods accepted include: cash, check, VISA and MasterCard.
  • Patients will be billed $25.00 for any returned checks.
  • Patients will be billed $100.00 for missing an in-office surgical procedure, $150.00 for vasectomy and all hospital-based surgical procedures and $25.00 for all other office appointments. An appointment may be cancelled and rescheduled by calling the office.
  • The recently implemented Health Insurance Portability and Accountability Act (HIPAA) requires physicians to obtain certification of patient identity. A drivers license or passport will suffice. Please kindly adhere to these new government regulations.

Medication Refills/Requests for Medical Records
The doctors prefer that patients receive their prescriptions during office visits. In the event a patient needs a written prescription, please deliver to our office a self addressed and stamped envelope so that we may mail the new or refill prescription to you. All requests for medication refills will be completed within 72 hours. No routine medication refills will be addressed at night or weekends. CALL IN PRESCRIPTIONS WILL BE LIMITED TO EMERGENCIES ONLY. Copies of medical records are available to patients and authorized representatives. A clerical and copy charge will be applied, payment due prior to our processing the request for records. Insurance forms, such as disability and life insurance, requiring the review of medical records by your physicians may also result in a clerical charge payable prior to the processing of these insurance forms. Please
contact the business office concerning these charges.

Life and death emergencies dial 911
There is a physician member of our group "on call" by pager at all times. The physician is available to answer questions of an urgent nature. The physician responding to calls after hours is often at home with his or her family and does not have access to patients' medical records. Therefore, we recommend that all routine concerns should be addressed during regular office hours. This allows your questions to be posed to your own health care provider who has then direct and immediate access to your medical record.