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:
  • In English: download pdf
  • En español: bajar
• 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 billing@imprimisurology.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 billing@imprimisurology.com.

Cancellation Policy: download pdf

HIPAA Notice of Privacy Practices: download pdf