Forms

Download Forms

Thank you for choosing Urology Specialists of Atlanta. For your convenience, we offer downloadable forms for you to complete prior to your appointment with us. You will also need to bring the following to your appointment:

  • A valid photo ID
  • Your current insurance card
  • Physician referral form
  • List of prescription and/or over-the-counter medications – including dosage
  • Information about your medical and surgical history
  • Recent x-rays, laboratory reports, or any other relevant medical information (please bring actual x-rays, CD ROMs if possible)

New Patients

For your first appointment: Please click on the links above, print out and complete BOTH forms and bring them with you. If you are unable or need assistance with the forms, please arrive at our office 30 minutes prior to your scheduled appointment time. You will also need to bring your current insurance card and photo ID.

Existing Patients

If this is your first visit in a new calendar year, or if there has been a change to your address or insurance since your last visit, please click on the two links above, print out and complete BOTH forms and bring them to your next appointment so that we may update your records accordingly. If this is not your first visit this calendar year, please only fill out the Returning Patient Medical History/Intake Form.

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Make an appointment so we can start helping you TODAY! 404-255-3822