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Patient Information

Hospital Affiliations | Your First Appointment | Patient Forms
Insurance and Payment Information | Privacy Practices

Hospital Affiliations

We are affiliated with the following medical facilities:

• Centennial Medical Center, Nashville, TN
• Centennial Surgery Center, Nashville, TN
• Centennial Medical Center at Ashland City, Ashland City, TN
• Greenview Medical Center, Bowling Green, KY

Your First Appointment

Please arrive 15 minutes early so that we can complete your initial paperwork. Also, please bring the following:

• Patient's insurance card
• Picture ID (such as driver’s license) or some other form of identification due to Red Flag Rules
• If your insurance requires a referral, please have your primary care physician fax the referral to our office prior to your appointment.
• List of current prescriptions and /or over-the-counter medication, including dose and frequency
• Information about patient's medical and surgery history
• Recent test results, x-rays, or relevant records

Patient Forms

[PDF Help]

Please print and complete the following patient forms before your office visit:

• Patient Registation (PDF)
• Health History (PDF)

Insurance and Payment Information

Center for Urological Treatment is a provider for Medicare and most major insurance plans and provides insurance billing. You are responsible for co-payments, referrals (if needed by your insurance plan) and charges that are not covered by your insurance. If you have questions regarding billing or which insurance plans we accept please contact us. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company. A photocopy of the patient's current insurance card will be in the patient's file to ensure prompt and accurate filing. Please notify our office of any changes to your insurance information.

Privacy Practices

Our Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. It is given to all new patients, and a copy is available upon request.

[PDF Help]

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