Patient Forms

Thank you for choosing Las Vegas Urology as your specialty health care team. We look forward to helping you soon!



Patient Forms
Notice of Privacy Practices for Las Vegas Urology

New Patients
We kindly ask that you arrive 15 minutes prior to your appointment so that we can ensure that all forms have been properly filled out.

New patient forms: Click the links below to download the forms.

New Patient Forms(Female)
New Patient Forms (Male)
New Patient Forms (Spanish)
Financial Policy Form
Financial Policy Form (Spanish)
No Show/Cancellation Form
No Show/Cancellation Form (Spanish)
Controlled Substance Opioid Consent Form
Controlled Substance Opioid Consent Form (Spanish)
New Patient Forms (Dr. Steinkohl's Patients ONLY)
Lithotripsy Consent Form (Dr. Goli's Patients ONLY)
Additional Patient Education Resources


Medical Records

All requests for the release of records must be submitted to our office in writing either via fax or U.S. mail. Please allow 48-72 hours for all requests for medical records to be processed. Please note that records released to attorneys, insurance companies, or any party other than another doctor's office may be subject to a fee of $0.60 per page to be remitted upon receipt of medical records.

You may use any of the following forms for the release of information.

Medical Records Release to Las Vegas Urology
Authorization to Release Records to an Outside Party
Authorization to Disclose Health Information to Family Member/Caregiver

Procedure Instructions
Many procedures done in our office require a certain amount of preparation on the part of the patient. Below are instructions on how to prepare for some of the more commonly performed procedures for our office.

Please follow instructions as closely as possible to ensure that accurate results.
BCG Biofeedback CAT Scan CMG Cystoscopy Doppler Kegel Exercises
Prostate Biopsy Self Catheterization Transurethral Microwave (TUMT) TUNA/Prostiva Uroflow Vasectomy

Post-Operative Instructions
Some procedures require some post-operative care.

The following are post-operative instructions for care after some of the more commonly performed procedures and surgeries done by our office.
Anti-Incontinence Surgery Cystoscopic Procedures Penoscrotal Surgery
Prostate Biopsy Prostatectomy Seed Implant Surgery
Stone Surgery Transurethral Microwave (TUMT) TUNA/Prostiva Cystoscopic Procedure