​​ Phone:  234-205-2040

Specializing in the diagnosis and care of pelvic floor disorders tailored to your needs


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 234-205-2040

New Patient Paperwork

To ensure your first visit goes smoothly, we ask that you complete our new patient survey to the best of your ability.  Not all questions will pertain to you.  Please be aware that if the paperwork is not completed at the time of your appointment, your appointment time may be delayed.

   

Please Bring The Following To Your Appointment:

                        -Completed new patient questionnaire

                        -Updated insurance cards

                        -If required by your insurance plan, please obtain a valid referral from                                    your Primary  Care Physician (PCP).

                        -Please arrive 10-15 minutes early to make sure all paperwork is in order.

We may need to obtain a urine specimen during your visit, so please arrive with a comfortably full bladder.  Of note, we are unable to provide annual exams and general gynecology services.

Please see our locations page for a google map to our two locations.

We look forward to meeting you.  We will do our best to provide you with the highest quality of care tailored to your personal needs and concerns.  Thank you so much for choosing Northeast Ohio Urogynecology.     

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