Patient Resources



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Appointment SchedulingOpen


Schedule an Appointment

Same-day appointments may often be available, so please call our office at 480.897.2727 ext. 108 if you want an appointment today.

If this is a medical emergency, please call 911.



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Items To Bring To Your AppointmentOpen


  • Insurance cards
  • Driver's license
  • Current medication and allergy list, including over-the-counter supplements, dosage and frequency
  • Physician referral forms, if required by your insurance, and the name of referring physician
  • Recent imaging reports/films/cd
  • Information about recent medical and surgical history


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What To Expect At The OfficeOpen


  • Please arrive 15 minutes prior to your appointment time
  • Be prepared to provide a urine sample
  • For new patients, a photo will be taken to confirm identity for future appointments
  • Co-payment and/or co-insurance will be collected on the day of service


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Insurance Plans AcceptedOpen


It's best to confirm your participation status with your insurance company or managed care plans. We are providers for Medicare and most major insurance plans. Common insurances we carry are:

  • Aetna
  • ACN Network
  • Ameriplan
  • Banner
  • BCBS
  • Carefirst
  • ChampVA
  • Cigna
  • Healthnet
  • Humana
  • Medicare
  • Mercy Care
  • Tricare/Triwest/Prime
  • UHC




Patient Forms

Save Time on the Day of Your Visit

Completing any necessary forms and returning them to our office before arriving for your appointment will save you time on the day of your visit. Click below to open the forms as PDF files.

Note: You may save the forms to your computer, and then type your answers directly into the forms. Once you are done, save the files, and then print them. You will still need to sign the forms before submitting them to our office.



PATIENT REGISTRATION FORM


PATIENT HISTORY FORM


RECORD RELEASE FORM


HIPPA NOTICE OF PRIVACY PRACTICES





Map to Southwest Urologic


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6007 E Baseline Rd STE 105
Mesa, AZ 85206

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480.897.2727
FAX 480.892.3035


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