Capital Urological Associates

P - 919.526.1717 ~ F - 919.790.0108 ~ info@capitalurological.com

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New Patient Info

Thank you for choosing Capital Urological Associates!  For your convenience and timeliness, we request that you bring the following when you come for your office visit:

  1. Your Insurance card(s).
  2. Your co-pay amount that will be requested at check-in time (we accept cash, debit cards, Mastercard and Visa).
  3. Your drivers license or another form of identification
  4. A list of your medications and allergies (along with your pharmacy name, address and phone number).
  5. The patient information form and medical history form. This is information that your Doctor will need in order to treat you properly.
  6. All relevant medical records, lab results, x-rays from your Primary Care Doctor (without this information our Doctor will not be able to evaluate you properly so we will have to reschedule your appointment). Men 40 + years should be sure to bring PSA lab results from their primary care doctor.
  7. Your Primary Care Doctor's name, address and phone number.
  8. Authorization number from your Primary Care Doctor's office faxed prior to your visit (if your insurance company requires an authorization.) Without the required authorization, you may be asked to sign a waiver and pay for your visit or reschedule your appointment.

For more information or to schedule your appointment call 919-526-1717.


New Patient Information Packet - Male

New Patient Information Packet - Female

Patient Forms are in pdf format and require Adobe Reader to open them.  
Adobe Reader is available as a free download from Adobe.com.




3320 Wake Forest Road, Suite 320, Raleigh, NC 27609  /  919-526-1717 /   info@capitalurological.com