What to bring to your appointment

• Your insurance card
• Physician referral forms if required by insurance
• A list of current prescription or over-the-counter medications you are taking, including dose and frequency
• Pertinent information about your medical and surgical history.
• Any recent x-rays or appropriate records you may have.

Payment and Insurance Information

Before seeing me, please check with your insurance carrier to verify whether I am a provider for your specific plan. Pre-authorization may be needed. Please obtain any needed pre-authorization or your visit may not be covered.

If you have insurance coverage, we will be happy to submit a claim for your care. In order to do this, we ask that you please bring your insurance card and all billing information with you.

If you do not have complete insurance information with you or you do not have insurance coverage, please be prepared to pay at the time of your visit.

Please remember that insurance coverage usually includes a yearly deductible and/or co-payment. This is the amount you are responsible for after your insurance carrier has made payments.

Patient Forms

The following forms can be completed on your computer before being printed and brought to your appointment:
[For help with pdf forms click here]

• Patient Information Form
• Current Medications Form

Any information you give me is strictly private. No records can be released to anyone-employer, friends, or relative-without your written permission.

• Privacy Acknowledgment Form

Emergency Calls

During the week, I take my own after hours call. I am reachable by cellular phone. If you call my office number instructions will be given.

In the event of a true emergency call 911 or go to the Emergency Department of Saddleback or Mission Hospital. The physician on duty will begin treatment and notify me.

Every other weekend, I alternate call with another Urologist. Call my office number for instructions.

I do take vacations with my family. If I am away, my nurse can contact the Urologist covering my practice. After hours, call my office number for instructions on how to call the Urologist on call.