What to Bring to the Appointment

• Patient's insurance card
• Physician referral if required by insurance
• A list of current prescription or over-the-counter medications the patient is taking, including dose and frequency
• Pertinent information about the patient's medical and surgical history, including any pertinent x-rays or records you may have

Patient Forms

We are pleased to offer you the opportunity to complete the forms on your computer (you can type directly onto the form), then PRINT THE COMPLETED FORMS and bring them with you to your appointment to help reduce your waiting time.

If you have any questions about these forms, please contact us at the practice directly.

[PDF Help]

• Patient Information Form
• Health History
• BPH Symptom Index - for males over 40

Insurances Accepted

We accept most major insurance plans including:

• Medicare
• Blue Cross/ Blue Shield
• United Healthcare
• Altius Health Plans
• Public Employees Health Program (PEHP)

Hospital Affiliations

• St. Mark's Hospital - Salt Lake City, Utah
• Alta View Hospital - Sandy Utah
• Salt Lake Regional Medical Center, Salt Lake City, Utah