Children's Urology Group

First Visit

When you call to schedule your first appointment, our staff will ask you a few questions about your child, the nature of your child’s condition, and their insurance coverage. The answers to these will help us best meet your needs.

At your first appointment, you will need to bring the following:

· Previous medical records, including x-rays or other studies, related to your child’s urologic condition.
· List of any questions you have relating to your child’s condition.
· Completed Patient Registration Form.
· Completed Patient Questionnaire.
· Completed Acknowledgement Form stating that our Notice of Privacy Practices Policy has been
reviewed and agreed to.
· Your Drivers License.
· Your child’s insurance card(s).
· Cash, check, money order, or credit card to pay your share of the cost of the visit. Newborn Circumcisions must be paid by cash or credit card only (no checks).
· A referral from your child’s Pediatrician/Family Practitioner, if required by your insurance company.
· Written authorization or custody paperwork, if the patient is under 18 years old and will not be accompanied by a
legal custodian.
· Prior to your appointment, you should review the following information:

· Financial Policy
· Participating Insurance List

If you need to cancel your child’s appointment, please do so at least 24 hours in advance.

Questions and Prescription Refills
If you have any questions about your child's care or need their prescription refilled, please call our office between 8 AM and 5 PM Monday through Friday.

Emergencies
One of our doctors is available after hours to handle situations that require immediate attention. Call our answering service at (727) 562-6859 and they will contact the doctor on call. In case of a life-threatening emergency, please call 911.

Medical Records Release Forms

Authorization For Release Of Medical Information Form

Authorization For Release Of Medical Information From Children's Urology Group To Other Facilities

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