North Idaho Urology
   
 

We at North Idaho Urology know that your time is valuable.  Please utilize the forms below so you may fill out your information at your convenience.  The following forms are designed to assist us in getting the most accurate information to make your appointment with us as efficient as possible.

 

- Patient Sign In
- Patient History Female
- Patient History Male
- Financial Policy

- Records Release
- Vasectomy Release
- Vasectomy Instructions

- Notice of Privacy Practices (HIPAA)

 
Patient Sign In
Patient History Female
Patient History Male
Records Release
Notice of Privacy Practices
       (HIPAA)
Financial Policy
Vasectomy Release
Vasectomy Instructions
Leave this field blank:



This unsecure e-mail is NOT for discussion of patient medical issues and we will not respond to any such requests. Communication by above methods does not constitute a doctor-patient relationship. If you have a medical emergency, please call 911 or your local emergency contact phone number

 



980 W. Ironwood Dr., Ste.104
Coeur d’Alene, Idaho 83814
Ph: (208) 667.0621
Fax: (208) 664-1709
M-F 8:00am-5:00pm

 

North Idaho Urology | 980 W. Ironwood Drive, Ste. 104 | Coeur d’Alene Idaho 83814 | Ph: (208) 667-0621 Fax: (208) 664-1709
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