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Diplomates American Board of Urology
Adult and Pediatric Urology • Sexual Dysfunction • Male Infertility

Patient Information

Your First Appointment |  Patient Forms | Insurances Accepted
Hospital Affiliations |  Notice of Privacy Practices

Your First Appointment

Please arrive early so that we can complete your initial paperwork. Also, please bring the following:

• Patient's insurance card
• List of current prescriptions and/or over-the-counter medication, including dose and frequency
• Information about patient's medical and surgical history
• Recent test results, x-rays, or relevant records
• Completed patient forms

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Patient Forms

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Please print and complete the appropriate forms before your office visit:

• Patient Intake Form
• Request to Copy Protected Health Information (Records Release)
• Request to Copy Protected Health Information
• Patient Authorization for Practice to Release Protected Health Information to Third Parties

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Insurances Accepted

Aetna/US Healthcare Horizon (Blue Cross/Blue Shield) Empire Health Plans NJ Carpenter Fund First Option GHI

Magnacare Medichoice Network Oxford PHCS Qualcare Excel care

Consumer Health Network Corporate Health Admin. CIGNA Prudential Medicare

We are happy to process all insurance forms for you as long as you have provided us with the appropriate insurance information. We expect payment promptly if you receive a bill from our office for balances that may be due. Please feel free to discuss any questions you may have about billing with office staff.

Consultants in Urology, P.A., is a provider for most major insurance plans. However, it is in your best interest to check your insurance providers list of participating physicians to be sure your plan allows you to be seen at our office. Also, please review with your insurance customer service representative (or insurance provider) the rules and limitations on coverage and reimbursement.

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Hospital Affiliations

Overlook Hospital 99 Beavoir Avenue PO Box 220 Summit, New Jersey 07901 Tel: 908.522.2000 view map >> Clara Maass Medical Center 1 Clara Maass Dr. Belleville, New Jersey 07109 Tel: 973.450.2000 view map >> Trinitas 225 Williamson St. Elizabeth, New Jersey 07202 Tel: 908.994.5000 view map >>

St. Michael's Medical Center University Heights 268 Martin Luther King Blvd. Newark, New Jersey 07102 973.877.5000 view map >> St. Barnabas Medical Center Old Short Hills Road Livingston, New Jersey 07039 973.533.5000 view map >> Stone Center of New Jersey 150 Bergen Street Newark, New Jersey 07103 973.982.7422 view map >>

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Privacy Practices

Our Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. It is given to all new patients, and a copy is available upon request.

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