What To Bring To Your Appointment | Patient Forms
Payment and Insurance | Privacy Practices

What To Bring To Your Appointment

• Your insurance card
• Physician referral forms if required by insurance
• A list of current prescription or over-the-counter medications you are taking, including dose and frequency
• Pertinent information about your medical and surgical history
• Any recent x-rays or appropriate records you may have

Patient Forms

Forms for female patients (PDF)
Forms for male patients (PDF)

[PDF help]

Payment and Insurance Information

Lancaster Urological Group is a provider for Medicare and most major insurance plans. We provide insurance billing. Anything not covered by insurance will be your responsibility.

We request payment at the time of your appointment for services that are not covered by insurance. Your insurance company may also require you to pay a co-payment at the time of your appointment. When necessary, our staff will work closely with patients who require a payment plan.

If you have any questions regarding which insurance plans we accept or any patient billing concerns, please call us at the phone number below. Questions regarding your coverage and benefits should be directed to your employer or insurance company.

Privacy Practices

This Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.