If you are requesting Worcester Urological Associates release your medical information, please print and complete the Patient Medical Record Release Form.
Please leave the following information when requesting refills:
Name of the patientPatient date of birthTelephone number where you can be reachedPharmacy name and telephone number
**If you have not been seen in this office, in the past 12 months you must schedule an appointment in order to receive a refill.
- Any recent lab work that has been performed(Urine Culture and Sensitivity, PSA History).
- Diagnostic tests done by your PCP or referring physician or hospital (CAT scan, Ultrasounds, MRI or X-rays.)
- Any medical records that relate to your current urological issue.
- A complete list of your prescription medications and over the counter medications including vitamin supplements.
- Insurance Cards and/or Referral forms
If you have an emergency after business hours or on a weekend please contact our office at 508-756-6293 and our answering service will page the doctor on call. When expecting a call from one the physicians, please disable your caller ID and or private/blocked call.
Surgeries are performed at either UMassMemorial-Memorial Campus and in some cases St. Vincent Hospital, both in Worcester, MA. Diagnostic work-ups are performed routinely at UmassMemorial, or a facility of your choice.
Unless other arrangements have been made by either yourself or your health coverage carrier, full payment for office services are due at the time of service
We have prior arrangements with many health plans to accept an assignment of benefits. You will be required to make the co-payment at the time of your appointment. Should your insurance require a referral and one is not obtained, you will be asked to sign a waiver, making you responsible for payment of services if no referral is received.