Patient Forms

Please download, print, and fill out our patient forms before your appointment.

New Patient Forms (2 pages) – Download
Infertility History Form (password required*) Download
*Use the contact form to request a password for this form.

Our Services

  • Prostate Health
  • Vasectomy
  • Kidney Stones
  • Infections
  • Bladder Control
  • Urologic Cancers


Schedule a vasectomy at our Las Vegas office click below Schedule a Vasectomy

Patient Forms

area map

Serving Mohave County and Northwest Arizonia

  • Bullhead City, AZ
  • Fort Mohave, AZ
  • Kingman, AZ
  • Lake Havasu City, AZ
  • Needles, CA
  • Laughlin, NV