• A picture ID
• Your insurance card
• Referral form if required by your insurance provider
• X-ray or other test results related to your condition
• Information about your medical or surgical history that pertain to the reason being seen
• Completed forms from this website (below)

Practice Forms

For your convenience, forms for your appointment are available online to review and complete in the convenience of your own home. If you are scheduled for an appointment with us, please print and complete the appropriate forms below. Fax the completed forms to our office or bring them with you to your appointment.

Information About You

New and returning patients are asked to print and complete the Registration, Health History, and Review of Symptoms forms below.

• Patient Registration [PDF]
• Patient History [PDF]
• Review of Systems [PDF]

Financial and Office Policy

All patients are asked to review and sign our Financial and Office Policy.

• Financial Policy

Health Information & Privacy Policy

All patients are asked to review our Notice of Privacy Practices and sign the Patient Consent for Use and Disclosure of Protected Health Information form.

• Notice of Privacy Practices
• Patient Consent for Use and Disclosure of Protected Health Information [PDF]

Symptom Score Profilers

If you are experiencing urinary symptoms, please complete the appropriate form below. Your doctor will use this score to help evaluate your condition.

• International Prostate Symptom Score [PDF] (for men only)
• AUA Symptom Score Index [PDF] (for women only)

Hospital Affiliations

• Spring Valley
• Southern Hills Hospital & Medical Center
• Sunrise Hospital
• Desert Springs
• Mountain View
• University Medical Center
• St. Rose de Lima
• Boulder City
• Valley Hospital
• Summerlin & several surgical centers