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  • Red Oak Drive (Houston, TX)
  • Cypress Station (Houston, TX)
  • St. Luke’s Way (The Woodlands, TX)
  • Dotson Road (Houston, TX)
  • Graham Drive (Tomball, TX)
• Our Physicians
  • Stuart Zykorie, M.D.
  • Howard Lippman, M.D.
  • Don Berardinucci, M.D.
  • Arnold Skor, M.D.
  • E.C. "Chip" Winkel, III, M.D.
  • Steven Sukin, M.D.
  • Patrick Zielie, M.D.
  • Howard Lewis, M.D.
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Patient Information

New Patient Forms
What to Bring to Your Appointment | Insurance and Payment

New Patient Forms

Use the following links to download forms that may be necessary for your appointment. Please call if you need clarification about which forms are needed. For the ones you need to fill out, please print a copy and complete the form. Please bring all completed forms to your appointment.
[PDF/printable page help]

• New Patient Registration Form [PDF]
• Consent for Purposes of Treatment, Payment and Health Care Operations [PDF]
• Authorization to disclose health information [PDF]
• Notice of Privacy Practices (For your information only)
• Acknowledgement of Receipt of Notice of Privacy Practices [PDF]

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What to Bring to Your Appointment

• Your insurance card
• Physician referral forms, if required by insurance
• List of prescriptions and/or over-the-counter medication, including dose and frequency
• Information about your medical and surgical history
• Recent x-rays or relevant records

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Insurance and Payment Information

Urology Specialists, P.A., is a provider for Medicare and most major insurance plans, and provides insurance billing. You are responsible for charges that are not covered by your insurance, at the time of your appointment.

Your insurance company may require a co-payment at the time of your appointment. When necessary, our staff will work with patients to set up a payment plan.

If you have questions regarding billing or which insurance plans we accept, please call us at the phone number below. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.

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What's New

Urology Specialists, PA, announces the opening of Willowbrook Radiation Oncology Center and also welcomes Dr. Howard Lewis—a Radiation Oncologist. Dr. Lewis was formerly with Scott & White.

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