Your First Appointment | Patient Forms
Insurance and Payment Information | Our Privacy Practices
Your First Appointment
Please arrive early so that we can complete your initial paperwork. Also, please bring the following:
- Patient's insurance card
- List of current prescriptions and/or over-the-counter medication, including dose and frequency
- Information about patient's medical and surgical history
- Recent test results, x-rays, or relevant records
Dr. Simon and Dr. Kurzer
For your convenience, the following printer-friendly PDF forms are available for you to print out, complete, and bring to your appointment:
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Dr. Kurzer examines a patient
Insurance and Payment Information
Broward Urology is a provider for Medicare and most major insurance plans, and provides insurance billing. You are responsible for co-payments or charges that are not covered by your insurance. If you have questions regarding billing or which insurance plans we accept, please contact us. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.
Our Privacy Practices
Our Notice of Privacy Practices describes how medical information about you may be used and disclosed in the course of your care
and how you can get access to your personal health information. It is given to all new patients and a copy is available upon request.
A copy of our Notice of Privacy Practices will soon be posted on this website.