Patient Resources

Patient Forms

We want to get you working with one of our healthcare professionals as quickly as possible. So please print and complete the patient information forms in advance of your visit and bring the completed form to your appointment.

If you are a new patient to Florida Urology Center, completing these forms before arriving for your appointment may help you save time. For billing questions please call 386-673-5100.

New Patient Forms

Download, print, and complete the New Patient paperwork.
Download PDF (751 KB)

Returning Patients

Download, print, and complete the Returning Patients form.
Download PDF (196 KB)

Medical Records Release

Download, print, and complete the Medical Records Release form.
Download PDF (84 KB)

What to Expect
Our pleasant staff is ready to assist and help you feel comfortable and informed about your treatment. Please call (386) 673-5100 with questions or concerns prior to your visit.

When you come to our office, please bring the following information:
● Your insurance card(s).
Appropriate medical documents, lab results, or x-rays to your first appointment.
A list of medications you are currently taking.
Any forms that were mailed to you by our office or your referring doctor.

Your First Visit
As mentioned above, please bring your insurance card(s) and a list of your current medications with you to your first visit. We recommend that you arrive for your appointment 20 minutes early to fill out any patient registration forms and a brief health history questionnaire. You may need to provide a urine sample as part of your exam, so please do not empty your bladder before seeing the nurse.

Payments and Insurance

Florida Urology is contracted with all major insurance companies. Our business personnel will bill your insurance company directly. All co-pays and deductibles are due at the time care is delivered. Once your insurance company payment is received, you will be billed for the patient responsible portion of your claim.

If we are not contracted with your insurance company, you will be asked to pay for your care when it is provided. In this case, we will provide you with the necessary paperwork to give to your insurance company so that you can be reimbursed directly.

If you have any questions about your insurance coverage or require assistance, please feel free to speak with someone in our billing department at 386-673-5100

Florida Urology Center, a state of the art facility is one of the only centers in the United States offering comprehensive radiation therapy for urologic cancers with patient centered care. That means from initial diagnosis to final treatment our team of caring, highly trained professionals are committed to placing your individual needs and your family first.

No Surprise Act


Hear What Our Satisfied Patients Are Saying...

“I have received exceptional care from the Florida Urology Center, and for this I am most grateful.”

G. M.

“We were very well pleased. We would highly recommend your office to anyone.”

M. D. and N. D.

“What a blessing it was to find Florida Urology Center.”

A. E.

“Thank you Florida Urology and PASC for taking great care of my wife, you are an absolute blessing to us.”

I. W.

“There are some great people at your facility and I am grateful they made it possible to take care of my serious condition.”

J. R.

“Nice staff. Great Doctors.”

A. G.

“Thank you for your excellent medical service, fine attention and great nursing staff.”

D. A.

“I pray that God watches over everyone in the Florida Urology Center.”

L. S.

“I would recommend the Florida Urology Center to anyone needing professional and compassionate care.”

E. H.

“Professional, efficient and the staff is caring and friendly. Wonderful experience!”

E. M.

“The staff was extremely professional and very friendly. Staff was also very patient in answering our questions.”

R. C.

“Everyone was wonderful to me, I feel like I was with my family.”

N. F.

“It can’t get any better than this! Everyone is very professional and courteous.”

A. F.

“Thank you to the Doctors and staff for providing me the most excellent care possible.”

J. T. and K. T.

“‘Two Thumbs Up’, ‘Five Stars’ and ‘A Big Thank You’ to the Florida Urology Center!

A. G.

“The staff and doctors are excellent. I always get immediate care when I’m having problems.”

L. T.

“We have had great care. Everyone has been so nice and helpful to us. Everyone goes way out to help.”

M.P. and B.P.

“Thank you, Florida Urology Center, for being there.”

E. B.

Call Today: 386-673-5100