Downloadable Forms

Your First Visit

Welcome to our practice. The links below will open our new patient information packets. This completed packet will provide your physician with information vital for your upcoming visit. Please complete the forms and bring the completed packet with you to your appointment. Our male patients may fill out the Sexual Health Inventory for Men, if it applies.

Form DescriptionDownload
New Patient Information MalePDF icon  DOWNLOAD FORM
New Patient Information FemalePDF icon  DOWNLOAD FORM
Release of Information FormPDF icon  DOWNLOAD FORM
Care Provision PoliciesPDF icon  DOWNLOAD FORM
Privacy Acknowledgement And Designated Party FormPDF icon  DOWNLOAD FORM
Urine Specimen Drop-Off FormPDF icon  DOWNLOAD FORM

Procedures, Conditions & Instructions

Certain Procedures require additional information for our patients.  Please refer to the following forms that detail your specific procedure and contact us with any questions.

Form DescriptionDownload
BalantisPDF icon  DOWNLOAD FORM
Bladder TumorPDF icon  DOWNLOAD FORM
Blood Thinning MedicationsPDF icon  DOWNLOAD FORM
Catheter Care InstructionPDF icon  DOWNLOAD FORM
Catheter Removal InstructionsPDF icon  DOWNLOAD FORM
Clean Intermittent Self-Catheterization (Female)PDF icon  DOWNLOAD FORM
Clean Intermittent Self-Catheterization (Male)PDF icon  DOWNLOAD FORM
Diet Clear LiquidPDF icon  DOWNLOAD FORM
Diet Full LiquidPDF icon  DOWNLOAD FORM
Diet Low Oxalate PDF icon  DOWNLOAD FORM
Cystoscopy and UreteroscopyPDF icon  DOWNLOAD FORM
Home Care of Your Ureteral StentPDF icon  DOWNLOAD FORM
Hydrocele and Spermatocele InformationPDF icon  DOWNLOAD FORM
HypospadiasPDF icon  DOWNLOAD FORM
Kegels How To Do Pelvic Muscle ExercisesPDF icon  DOWNLOAD FORM
Mitomycin Bladder InstillationsPDF icon  DOWNLOAD FORM
Neobladder Home Care InstructionsPDF icon  DOWNLOAD FORM
Penile Injection Information SheetPDF icon  DOWNLOAD FORM
ProstatitisPDF icon  DOWNLOAD FORM
Suprapubic Catheter Home Care (SP Tube)PDF icon  DOWNLOAD FORM
Undescended Testes (Cryptorchidism)PDF icon  DOWNLOAD FORM
Prostatectomy Da Vinci RoboticPDF icon  DOWNLOAD FORM
Prostatectomy Retropubic RadicalPDF icon  DOWNLOAD FORM

Post Operative Instructions

Many times after surgical procedures patients have a difficult time recalling the discussion of postoperative care. The following forms will help you with most of your concerns. Please feel free to contact us with any questions pertaining to your postoperative care.

Form DescriptionDownload
AdrenalectomyPDF icon  DOWNLOAD FORM
Bladder Suspension Post-OpPDF icon  DOWNLOAD FORM
Circumcision Post-OpPDF icon  DOWNLOAD FORM
(ESWL) Post-OpPDF icon  DOWNLOAD FORM
Holmium Laser Enucleation of Prostate Post-OpPDF icon  DOWNLOAD FORM
Nephrectomy and Renal Cryotherapy Post-OpPDF icon  DOWNLOAD FORM
Male SlingPDF icon  DOWNLOAD FORM
Male Sling for IncontinencePDF icon  DOWNLOAD FORM
Nephrectomy Post-OpPDF icon  DOWNLOAD FORM
Percutaneous Nephrolithotomy Post-OpPDF icon  DOWNLOAD FORM
Prostate Ultrasound and Biopsy InstructionsPDF icon  DOWNLOAD FORM
PVP Post-OpPDF icon  DOWNLOAD FORM
Radical Cystectomy Post-OpPDF icon  DOWNLOAD FORM
Robotic and Radical Prostatectomy Post-OpPDF icon  DOWNLOAD FORM
Transurethral Resection of a Bladder Tumor Post-OpPDF icon  DOWNLOAD FORM
Transurethral Resection of Prostate Post-OpPDF icon  DOWNLOAD FORM
Vaginal Sling and TVT Post-OpPDF icon  DOWNLOAD FORM
Vasectomy Post-Operative InstructionsPDF icon  DOWNLOAD FORM
Vasovasotomy (Vasectomy Reversal) Post-OpPDF icon  DOWNLOAD FORM

Five Valleys Urology is Moving!

Starting 4/27, our offices will be located at:

2875 Tina Avenue, Suite 101
Missoula, MT 59808
Map Link »

Please note the following dates:

We will be closing our current North Office (601 W Spruce St Ste G) on 4/22/11.

The South Office (2831 Fort Missoula Rd - Physician Center II, Ste 105) will remain open until 4/26/11.

We'll begin seeing patients in our new office beginning 4/27/11.

Please Contact Us with any questions. We look forward to showing you our new space!