Spend less time in the waiting room!

You can Prepare for your office visit by downloading and printing your intake forms to complete at home

• Registration information: page 1 | page 2
• Medical history form: page 1 | page 2
• Consent for disclosure form

This form gives your consent for the Clinic of Urology, S.C. to use and/or disclose your protected health information to carry out treatment, payment, or health care operations.

• Release of medical information/Doctor dialogue with family members form

This form gives your consent for the Clinic of Urology, S.C. to discuss your treatment with the family member specified.

• Clinic of Urology, S.C. Notice of Privacy

Federal law requires to Clinic of Urology inform its patients about the ways that Clinic of Urology may use and disclose your protected health information. In addition, federal law requires Clinic of Urology to inform patients of your rights regarding disclosures of your health information. This notice details this policy for your information.

• Patient financial policy