Same Day or Ambulatory Surgery Centers
- Surgical Center of South Jersey - Mt. Laurel, NJ
- Midlantic Stone Center- Marlton, NJ
- Summit Surgical Center - Voorhees, NJ
Registration Form
If this is your child's first visit with us, please print and complete our registration form. Fax the completed form to the office where your child is being seen or bring it with you to the scheduled appointment.
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Information Sheets
Discharge Instructions
Enuresis (Bedwetting) Questionnaire
What to Bring to Your Appointment
- Insurance card
- Co-payment and physician referral forms, if required by the insurance provider
- List of current medications, including the dose and frequency
- Information about the patient's medical and surgical history
Insurance and Payment Information
Urology for Children, LLC, is a provider for most major insurance plans. You may be responsible for charges that are not covered by your insurance, at the time of your appointment.
You may be responsible for a co-insurance. When necessary, our staff will work with you to set up a payment plan.
If you have questions regarding billing or which insurance plans we accept, please call us at the phone number below. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.
