Patient Forms and Policies
Your First Appointment
Please arrive 30 minutes prior, so that we can complete your initial paperwork. Also, please bring the following:
- Patient insurance card
- Patient photo ID
- List of current prescriptions and/or over-the-counter medication, including dose and frequency>
- Information about patient’s medical and surgical history
- Recent test results, x-rays, or relevant records
Patient Forms
Before your appointment with us, please register through our portal and fill out patient forms from our practice. If you are unable to login, please download, print and bring these forms with you to your appointment.
Online Forms
Please complete the appropriate packet at least 3 days prior to your appointment. If you are unable to complete online, please arrive 30 minutes prior to your appointment time.
New Patient Packets
- Packet A (New Patient Forms)
- Packet B (New Patient, Erectile Dysfunction Forms)
- Packet C (New Patient, Infertility Forms)
- Packet D (New Patient, Vasectomy Consult Forms)
Additional Forms
Print Your Forms
To view the forms listed below, you will need to download Adobe Reader. Please print, complete and bring your completed forms with you to our urology office at the time of your visit.
New Patient Packets
- Packet A (New Patient Forms)
- Packet B (New Patient, Erectile Dysfunction Forms)
- Packet C (New Patient, Infertility Forms)
- Packet D (New Patient, Vasectomy Consult Forms)
Additional Forms
Download Office Policies
Hospital Affiliations
- Forbes Regional Hospital
- Southwestern ASC
- UPMC, East
- Jefferson Regional Medical Center
- AHN Monroeville Surgery Center
- Greater Pittsburgh Surgery