YOUR FIRST VISIT TO SOCAL UROLOGY INSTITUTE?
Your First Appointment
Please arrive early so that we can complete your initial paperwork. Also, please bring the following:
- Patient’s insurance card
- List of current prescriptions and/or over-the-counter medication, including dose and frequency
- Information about patient’s medical and surgical history
- Recent test results, x-rays, or relevant records
These forms are provided for your convenience so they may be filled out prior to your office visit.
- Male Patient Packet
- Female Patient Packet
- ADAM testosterone deficiency questionnaire
- Notice of Privacy Practices
- Privacy Practices acknowledgment
Insurance and Payment Information
Dr. Bellman is a provider for Medicare and most major insurance plans, and provides insurance billing. You are responsible for co-payments or charges that are not covered by your insurance. If you have questions regarding billing or which insurance plans we accept, please contact us. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.
Our Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. It is given to all new patients, and a copy is available upon request.
Dr. Bellman routinely makes use of the facilities at Avanguard Surgery Center to perform advanced procedures.