· Previous medical records, including x-rays or other studies, related to your childs urologic condition.
· List of any questions you have relating to your childs 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 childs 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 childs 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 childs appointment, please do so at least 24 hours in advance.
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