Patient Forms

One of our goals is to reduce your wait time to see the doctor. If you are a new patient and you have the time and the ability, please print and fill out these two forms.

Adult History & Review of Systems Questionnaire

Signature Page for HIPAA Privacy Policy & Medical Release Form

If you would like to read or print the full HIPAA Privacy Policy & Medical Release Form click here.

Downloadables

For your convenience, we have placed all other forms, quizzes, diets, and other downloads from our website in one place:

BPH Symptom Score Index

Find out if you may have an enlarged prostate by answering a few questions.
Download

GreenLight Brochure

Learn more about treatment for an enlarged prostate.
Download

Oxalate Diet

If you have been advised to monitor Oxalate intake with your meals, click here for a diet plan that lets you know which foods are Little or No Oxalate, Moderate Oxalate, or High Oxalate.
Download

Medications To Avoid Before Surgery

If you’re about to have surgery, there are several mediations you will need to avoid as they are blood thinners and this can cause your surgery to be rescheduled or cancelled.
Download