Patient Information
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Forbes Regional Hospital 2570 Haymaker Road Monroeville, PA 15146 412.858.2000 |
Jefferson Regional Medical Center 565 Coal Valley Road Clairton, PA 15025 412.469.5000 |
| UPMC, Monroeville Surgery Center 125 Daugherty Drive Monroeville, PA 15146 412.374.9385 |
Southwestern ASC 500 Lewis Run Road West Mifflin, PA 15122 412.469.6964 |
| Excela Health, Norwin Medical Commons 8775 Norwin Ave North Huntingdon, PA 15642 724.527.8060 |
Please arrive early so that we can complete your initial paperwork. Also, please bring the following:
| New patient packets: | Additional forms: |
Insurance and Payment Information
Suburban Urologic Associates is a provider for Medicare and most major insurance plans, and provides insurance billing. You are responsible for co-payments or charges that are not covered by your insurance. If you have questions regarding billing or which insurance plans we accept, please contact us. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.
Our Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. It is given to all new patients, and a copy is available upon request.
Patient Forms
New patient packets:
Packet B
(new patient, erectile dysfunction forms)
Packet C
(new patient, infertility forms)
Packet D
(new patient, vasectomy consult forms)
Packet E
(established patient forms)
Additional forms:
Medical Records Release
AUA BPH Symptom Scale
Pelvic Pain and Urgency/Frequency Symptom Scale
Voiding Diary