YOUR FIRST VISIT

We 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

New Patient Registration Form 1
Males only – Form 2

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:

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:

Please note that if you are insured by the 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:

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:

TAKE SOME PATIENT HISTORY including:

Bringing a list of this information can be helpful

TAKE YOUR VITAL SIGNS, including:

ASK FOR A URINE SPECIMEN

CHECK OUT from 1st Visit:
After you have seen the doctor, you will proceed to the check-out area. The scheduler will: