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Call Us Today
(216) 941-0333
Call Us Today
(216) 941-0333

Registration Form

Dear Patient:
Welcome to our practice!  You currently have an appointment to visit our office.  Our records indicate that you are either new to our practice or have not been seen in three years.
In preparation for your visit, please fill out the electronic registration form. Be as thorough as possible when filling out your personal information and medical history.  This will save us time on the day of your appointment, and will help us provide you the best medical care.  After completing the secured registration forms, just click submit and we will receive your paperwork through our secure email. 
Present your driver license or personal identification along with your current insurance cards at the time of check-in.  Your copayment is required to be paid at that time also.  If your health insurance program requires a referral, it is the patient’s responsibility to obtain a referral from your Primary Care Physician PRIOR to seeing our Specialist.  We must have the referral in our office by the time of your appointment.  If it is not, your appointment may be rescheduled or you can sign an insurance waiver to accept financial responsibility for the office visit.  Make sure you check your insurance for your allowed hospital network, laboratory and/or x-ray requirements.
Urology Partners is excited to tell you that we now have a patient portal available.  This portal provides a secure, convenient and personal way of managing your health care and communications with Urology Partners staff online.  The patient portal will grant you access to update your personal health information, as well as, communicate with us at your convenience.  In addition, you can access the portal via your mobile advice.
Once you complete the electronic registration form , simply click on the “Follow My Health” icon (green shield) and choose “Create a New Account.”  It will lead you through the process of joining the portal then allow you to create a user name and password.  The portal allows you to have real-time access to your medications, clinical summary, and upcoming appointments.  You will also be able to request appointments, prescription renewals, update demographic information, and send messages to our office.  There are many other features available on the portal and many more to come in the future.   
Thank you for choosing Urology Partners for your urological care.  If you have any questions, please contact the office.

Sincerely,
Urology Partners, LLC

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