Progressive Urology, PC

Patient Portal
Appointments: 219.324.3120

Patient Forms

At Progressive Urology, our top priority is our patients. We strive to provide our patients with excellent urologic care in a professional and compassionate environment. In order to ensure that your visit with us goes even more smoothly, we've created these resources to help you to prepare for your appointment.

Making an Appointment

You can schedule your appointment or someone from your referring physician's office can schedule it for you. To make an appointment, please call us (219) 324-3120 Monday through Friday 9:00 am to 5:00 pm.

What to Bring

If you are already a patient of our practice, please bring the following information to your appointment:

  • A list of all current medications and dosages, including all-over-the counter medicines, vitamins, and herbal supplements that you take.
  • Your up-to-date insurance card.
  • Your updated phone numbers and address if they have changed

If you are a new patient, please bring the following with you to your appointment:

  • Your social security number
  • Your insurance information: If you have an insurance card, bring it. To bill your insurance company, we wil need the name of the company, complete mailing address, your policy's group number, and your personal identification number. If your insurance company requires a referral, please bring it with you to your first appointment. If you are covered by Medicare or Medicaid, please bring the appropriate card, too.
  • A list of any surgeries that you have had in the past.
  • A list of your current medications and dosages, including all-over-the counter medicines, vitamins, and herbal supplements that you take
  • Your co-payment: Co-payment is due at the time of your practice visit. You also may be asked to pay for services not covered by your insurance.
  • Cash, debit card, check or major credit card (Visa, Mastercard, and Discover Card).

Prescription Refills

Your prescription can be refilled through our office, either during your visit or by phone. To request a prescription refill, please call the office at (219) 324-3120 Monday through Friday 9:00 am to 5:00 pm.

Records Request

Records Request

You may need to request a copy of your records from us to be shared with another physician. We are happy to provide you with a copy of your record at no charge. For the sake of privacy, we ask that you sign a release form when you request your records. Please allow one week for processing of all medical records and medical forms.

Before your appointment with us, quickly and conveniently access patient forms from our practice.

DocumentDownload Patient Forms

Get Adobe AcrobatTo view the forms listed below, you will need Adobe Reader. You may download Adobe Reader for free at www.adobe.com. Please bring your completed forms with you to our office at the time of your visit.