Patient Forms & Policies for Urology of Indiana

Online Patient Forms

Your request will be processed within 24 hours, during normal business hours. If you do not receive confirmation of your request within 48 hours, please contact our office by phone at (877) 362-2778.

• Online Appointment Request Form

See our Clinic Policies for Testosterone Therapy

Download Patient Forms

Before your procedure with us, quickly and conveniently access post-operative instruction forms from our practice.

To view the forms listed below, you will need to download Adobe Reader.

Patient Intake Forms

• Erectile Dysfunction
• Peyronie’s Disease
• Male Infertility
• Male Bladder Leakage
• UroPlan Prostate Cancer Survivorship
• Low Testosterone
• Vasectomy Reversal

Surgery Education Forms

• Inflatable Penile Implant Placement
• Microsurgical Vasectomy Reversal
• Microsurgical Varicocele Repair
• Scrotal Surgery
• Male Sling Placement
• Penile Reconstructive Surgery
• Vasectomy
• Artificial Urinary Sphincter Placement
• JP Drain Care Instructions

Medication Policy Forms

• Practice Provided Medications