New Patients / Downloadable Forms

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The Center for Urology is here to assist you with any urology concerns you may have. Feel free to contact us using the information below to schedule an appointment.

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Current patients can enter the Patient Portal using this link.  You can use this link to pay your bill.

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New Patients:

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• New Patient Packet for Women (9 MB) 

• New Patient Packet for Men (14 MB) 

 

Additional Forms:

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• Directions to Our Clinic

• Mission and Vision Statements

• Patient Grievance Form

• Patient Privacy Policy

• Authorization to Disclose Protected Health Information Form (3 MB)

• Pay Your Patient Bill using this link

• Good Faith Estimate and No Surprise Billing

• ​Estimación de buena fe y facturación sin sorpresas (español)

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Note: Please bring the completed forms to the office at the time of your appointment.  Contact us if you have any questions!

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Insurance Plans:

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The Center for Urology is contracted with many health plans and we will submit a claim to your primary, secondary and tertiary insurance plans as a courtesy to our patients. However, primary responsibility for the account is yours.  Please check with your plan prior to your visit to see if there are referral requirements on your plan. 

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Contracted Insurances

• Aetna

• Aetna Medicare Advantage

• Care Oregon Medicare Advantage

• Cigna

• Cigna Medicare Advantage

• HealthNet

• Healthnet Medicare Advantage

• Human Choice Care

• Humana Medicare Advantage

• Medicare

• MODA

• MODA Medicare Advantage

• PacificSource

• PacificSource Medicare Advantage

• Providence

• Providence Medicare Advantage

• Regence

• Regence Medicare Advantage

• Tricare

• United Healthcare

• United Healthcare Medicare Advantage

 

Contracted Networks

• Coventry

• First Choice Health Network

• MultiPlan

• PHCS

• Providence Preferred

 

Oregon Medicaid Plans

• CareOregon

• Providence

• Pacificsource

• Open Card

 

If you have any insurance-related questions, please call our billing office at  (971)274-2392 or contact us.

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