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Forms and Insurance
Prepare for Your First Appointment
- Bring insurance documents and photo id to your appointment
- Remember documents from other offices needed for this visit.
- Download and complete patient forms:
- Please avoid urinating just prior to your visit as you may be asked to provide a urine sample.
- Your co-payment is due at the time of your visit.
Do you have insurance questions?
Imprimis Urology is in-network with most major insurance carriers. If you have any questions regarding coverage, please contact our Insurance/Billing Manager at 336.584.6300 or email at email@example.com.
Do you have questions about your bill?
If you have any questions, please contact our Insurance/Billing Manager at 336.584.6300 or email at firstname.lastname@example.org.
Cancellation Policy: download pdf
HIPAA Notice of Privacy Practices: download pdf