2001 Marcus Avenue - Suite N 214

Lake Success, New York 11042

516-437-4228

516-355-0637

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Patient Resources

We look forward to meeting you on your first visit to our office. During this time, we will help you get acquainted with our office and learn about your urology treatment. We understand that each patient’s treatment is different, and we promise to give you the personal attention you deserve. We also know that your time is a precious commodity, so we have our Patient Information and Office Policies forms here for you to download and complete for your first visit with our office.


Forms

You can easily view and print the necessary patient forms using the links below:

PATIENT VISIT FORMS

pdf-iconFemale Patient History – English

pdf-iconFemale Patient History – Spanish

pdf-iconInternational Prostate Screening Score Form (IPSS)

pdf-iconMale Patient History Form – English

pdf-iconMale Patient History Form – Spanish

pdf-iconPatient Registration – English

pdf-iconPatient Registration – Spanish

pdf-iconAcknowlegement of Privacy Practices Form – English

pdf-iconAcknowlegement of Privacy Practices Form – Spanish

pdf-iconNotice of Privacy Practices – English

pdf-iconNotice of Privacy Practices – Spanish

pdf-iconProstate Biopsy Consent Form

 

INFORMATION & INSTRUCTION SHEETS

pdf-iconCystoscopy Instructions

pdf-iconPost Biopsy Instructions

pdf-iconPost Biopsy Instructions – Anesthesia

pdf-iconPost Biopsy Instructions – Sedation

pdf-iconProstate Biopsy Instructions

pdf-iconUrodynamics Instructions

pdf-iconVacectomy Instructions

pdf-iconVacectomy Post Operative Instructions

pdf-iconVasectomy Information

 

POST-OP FORMS

pdf-iconFollow-up Form – English

pdf-iconFollow-up Form – Spanish

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