What to Bring to Your Appointment
We accept most major insurances. Please be sure to bring your insurance card, referral if necessary, identification, and a list of medications to your office visit. Please arrive early to your first appointment to allow time to complete your medical history and demographic forms.

Patient Forms
If you are a new patient to our practice, please print and complete the Registration Form, Notice of Privacy Practices Receipt Form, Patient Consent to the Use and Disclosure of Health Information Form, Release of Billing & Medical Information Form, and if applicable, any of the other forms; it will save you time the day of your appointment.

• Welcome Letter [PDF]
• Patient Registration Form [PDF]
• Financial Policy Form [PDF]
• Notice of Privacy Practices [PDF]
• Notice of Privacy Practices Receipt Form [PDF]
• Patient Consent to the Use and Disclosure of Health Information for Treatment, Payment and Healthcare Operations Form [PDF]
• Release of Billing & Medical Information Form [PDF]
• Review of Systems Form [PDF]
• Medication Flow Sheet Form [PDF]

[information on accessing and printing forms]

Procedure Information

• Vasectomy Information [PDF]

Hospital Affiliations
For our patients' convenience, our practice is affiliated with:

• Williamson Medical Center - Franklin, TN
• Williamson Surgery Center - Franklin, TN
• Cool Spring Surgery Center - Franklin, TN
• Maury Regional Hospital - Columbia, TN
• Centennial Medical Center - Nashville, TN

Insurance Plans
We participate in the following insurance plans:

• Medicare
• Cigna
• United Healthcare
• Aetna
• Great West
• First Health
• HealthSpring 65 HMO and PPO
• Blue Cross/Shield of Tennessee Networks P, S and C
• Signature Health Alliance
• Choice Care
• Humana Gold Choice
• Windsor Medicare

Notice of Privacy Practices
Franklin Urological Associates wishes to present a document outlining its privacy practices.