Patient Resources
Your Appointment
Thank you for choosing Five Valleys Urology as your Urologic care provider. We provide multiple ways for you to interact with our office and see your provider. From face-to-face visits to Telehealth, and from in-office procedures to expert surgical care in a hospital or surgery center, Five Valleys Urology provides a comprehensive care approach designed around your individual needs.
Please contact our office with any questions.
New & Established Patients
The links below will open information packets for your visit. Almost always we will send these to you electronically when your appointment is made, however you can access the information below as well. Whether you fill out your forms electronically or by the links below, returning the information to our office prior to your visit will save you time and ensure we have everything we need to provide you with appropriate care.
| Form Description | Download |
|---|---|
| Authorization to Release Information Via Email | Download |
| Care Provisions Policies 2022 | Download |
| Established Patient Update Packet (Print) | Download |
| Established Patient Update Packet (Fillable Form) | Download |
| IPSS Symptom Score | Download |
| New Patient Intake Packet (Print) | Download |
| New Patient Intake Packet (Fillable Form) | Download |
| Urinalysis Specimen Drop Off Form | Download |
Self-Care Instructions & Procedure Information
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 Description | Download |
|---|---|
| Catheter Care Instruction | Download |
| Catheter Removal | Download |
| Clean Intermittent Self-Catheterization Instructions (Female) | Download |
| Clean Intermittent Self-Catheterization Instructions (Male) | Download |
| Clear Liquid Diet Instructions | Download |
| Cystoscopy and Ureteroscopy | Download |
| Da Vinci Prostatectomy | Download |
| Foods To Eat And Avoid During UTI | Download |
| HoLEP | Download |
| Hydrocele | Download |
| Instructions For Home Care of Ureteral Stent | Download |
| Kegels: How To Do Pelvic Muscle Exercises | Download |
| Neobladder Home Care | Download |
| Prostate Biopsy Instructions | Download |
| Prostatitis | Download |
| Retropubic Radical Prostatectomy PT Information | Download |
| Suprapubic Catheter Home Care | Download |
Post-Procedure 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 Description | Download |
|---|---|
| Cystectomy Post-Op Instructions | Download |
| ESWL Post-Operative Instructions | Download |
| Holmium Laser Enucleation of Prostate | Download |
| Male Sling | Download |
| Nephrectomy and Renal Cryotherapy Post-Operative Instructions | Download |
| Nephrectomy Post-Operative Instructions | Download |
| Post-Operative Instructions for Scrotal Surgeries | Download |
| After Your Prostate Biopsy | Download |
| Robotic and Radical Prostatectomy Post-Operative Instructions | Download |
| TURP Bipolar Post-Operative Instructions | Download |
| Vaginal Sling Post-Operative Instructions | Download |
| Vasectomy Post-Operative Instructions | Download |
| Vasovasostomy Post-Operative Instructions | Download |