NEW PATIENT INFORMATION

New Patient Forms

Use the following links to download forms that may be necessary for your appointment. Please print and complete the form. Please bring all completed forms to your appointment.

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

Hospital Affiliations

  - Conroe Regional Medical Center
  - Memorial Hermann in The Woodlands
  - St Luke's The Woodlands Hospital
  - Houston Methodist Hospital

 

Insurance and Payment Information


Tharian Urology is a provider for Medicare and most major insurance plans, and provides insurance billing. You are responsible for co-payments or 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.
   

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.

© 2023 THARIAN UROLOGY  |  ALL RIGHTS RESERVED  |  CREATED BY SHELLSHOCKSTUDIO

  • Grey Facebook Icon
  • Grey Twitter Icon