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Dear Patient, Thank you for choosing our office for your urologic care. Below is a questionnaire that will thoroughly review your past history and other factors that may affect your health. This will help me focus on areas that may require additional attention. On your first visit, please bring reports of recent laboratory tests and if you have had x-rays done, bring the films with you. Please obtain copies of your previous urologist's notes; you may need to sign a release for these and it may take two weeks for the information to be sent. Diagnostic tests may be recommended on your first visit: urine or blood tests, radiology studies, cystoscopy, prostate biopsy, or urodyanmic studies. These will need to be scheduled and most will require you to return for the results and to discuss a treatment plan. Please bring your insurance card(s) with you. Payment is expected when service is rendered. Location: Our office is next to Good Samaritan Hospital, in the Victor Farris Building, Suite 5100. Valet parking is available. Appointments: Occasionally, your scheduled appointment might have to be changed due to surgery or emergency cases. We do our best to try to stay on a timely schedule. However, this is not always possible and you may have to wait for your appointment. We apologize for these unavoidable delays. Because of increasing demand and as a courtesy to other patients, we require a 24-hour notice for appointment cancellation. Telephone Calls: Our receptionist answers all calls. You may request to have the medical assistant return your call. Those calls that require a doctor's attention will be returned as soon as possible. Emergencies: After hours, phone 561.650.0815 and the answering service will contact the urologist on-call. You may also go to a hospital emergency room, where the emergency room doctors will see you. Prescription Refills: We will refill certain medications by phone from Monday-Friday, 9 a.m. to 4 p.m. Please call at least three days before your prescription runs out. My staff and I look forward to providing you with the highest quality of care, in the most courteous and efficient manner possible. We are dedicated to providing health care with excellence, personal attention, and from the heart. Welcome!
Sincerely yours, Please download, print out, complete and bring the following forms to your office visit. [For PDF forms, you may need to consult printable/PDF page help.]
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DANIEL K. HELLERSTEIN, M.D., P.A.
1411 North Flagler Drive
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