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Patient Information


























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Associated Urologists

What to Bring to Your Appointment
Patient Forms
Patient Instructions
Payment and Insurance
Hospital Affiliations
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
We do provide interpreters for Russian, Korean, and Spanish for your convenience.

Patient Forms

For your convenience, please print and complete the following patient form before your office visit:

[PDF Help]

Patient Instructions

Payment and Insurance Information

Associated Urologists 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.

For a list of our insurance plans click here.

Hospital Affiliations

Privacy Practices

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.



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Associated Urologists
5140 N. California
Suite 775
Chicago, IL 60625

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9669 North Kenton
Suite 309
Skokie, IL 60076

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Tel: 773.878.7555
Fax: 773.878.8545