What to Bring to Your Appointment

• Your insurance card
• Physician referral forms if required by insurance
• A list of current prescriptions and/or over-the-counter medications you are taking, including dose and frequency
• Pertinent information about your medical and surgical history
• Any recent x-rays or appropriate records you may have
• Any recent blood work results

Insurance and Payment Information

Tri City Urology is a provider for Medicare and most major insurance plans. We provide insurance billing. Anything not covered by insurance will be your responsibility.

We request payment at the time of your appointment for services that are not covered by insurance. Your insurance company may also require you to pay a co-payment at the time of your appointment. When necessary, our staff will work closely with patients who require a payment plan.

If you have any questions regarding which insurance plans we accept or any patient billing concerns, please call us at the phone number below. Questions regarding your coverage and benefits should be directed to your employer or insurance company.

Hospital/Facility Affiliations

• Bay Medical Regional Center
• Covenant HealthCare
• MidMichigan Regional Medical Center
• Saint Mary's Medical Center

Patient Forms, Information Sheets, & Instructions

We are pleased to offer you the opportunity to print our forms, information sheets, and patient instructions at your convenience from this website.

To print these materials you must have the Adobe Acrobat Reader on your computer. Download this program free of charge by clicking on the Get Acrobat Reader button. Follow the on-screen instructions, and the download will take just a few minutes to complete. If you already have the Adobe Acrobat Reader, simply click on the item you want to view and print.

Patient forms

• General patient information
• Patient health history

• Kegel exercises
• Transrectal ultrasound and biopsy
• What to do when you have the urge?

• Cystoscopy
• Female incontinence
• Impotence
• InterStim Therapy for Urinary Control
• Prostate cancer
• Testicular cancer
• Transrectal ultrasound and biopsy
• Urethral syndrome in women
• Urinary tract infections
• Urodynamic testing/CMG
• Vasectomy, the no-scalpel approach