Your First Visit

Central Arizona UrologyWe are constantly striving to make our offices more efficient. Please bring these completed forms to our office prior to your first appointment. By doing so, we will be able to assist you more efficiently when you arrive.

Please take a few moments to print and complete the following forms

As required by law, we are providing you a copy of our Notice of Privacy Practices. We do not require you to print this information however, we are obligated by law to require that we have your written acknowledgment of receiving this information on file. Please review this information prior to signing the acknowledgment form.

Please remember the following items for your first appointment:

  • If your insurance company requires a referral, please bring it with you.
  • Please be prepared to make your co-payment prior to seeing the nurse and/or doctor.
  • If you have x-rays, medical records, lab results or other pertinent medical history, please bring those with you.
  • When you come for your appointment, please arrive 15 minutes early so that we may process your information.
  • You may need to provide a urine sample as part of your exam, so do not empty your bladder before seeing the nurse.

When you arrive, please pick up a copy of our practice brochure at the front desk or in the lobby. This will give you further information about our practice. Thank you again for choosing Central Arizona Urologists. We look forward to seeing you.

WHAT TO BRING for 1st visit:

  • All insurance cards or claim forms
  • Drivers Licence or photo ID
  • Medical records, x-rays, and other laboratory tests
  • Complete list of medications, prescriptions, and over the counter (list or bottles)
  • Physician-to-Physician referral form, if applicable
  • Please note that if you are insured byt managed care plan (HMO), it’s your responsibility to obtain your referral from your primary care physician. Please bring a completed referral information form to your appointment. Payment, including co-pays, is expected at the time service is rendered for all office visits and procedures

CHECK-IN for 1st Visit:

Our friendly reception staff will assist you by:

  • Confirming that your new patient forms are completed properly
  • Providing you with a Notice of Privacy Practices for Central Arizona Urologists
  • Taking copies of your insurance cards
  • Insurance co-pays
  • Notifying the doctor of your arrival

IN the ROOM for 1st Visit:

Once you have completed your new patient registration forms, the nurse will escort you to the exam room. At that time she may:


  • Current medications
  • Current medical conditions
  • Current/previous physicians

Bringing a list of this information can be helpful


  • Height
  • Weight


CHECK OUT from 1st Visit:

After you have seen the doctor, you will proceed to the check-out area. The scheduler will:

  • Set up your next appointment
  • Schedule any diagnostic testing that the doctor has ordered at the appropriate facility
  • Send for records request as necessary from a previous physician or hospital.