780 Main Street,
South Weymouth, MA 02190

Patient Resources

From your first contact with our practice, we strive to exceed your expectations in every encounter by providing prompt, courteous service. Our staff is devoted to respecting and responding to your needs and those of your family members.

Please bring to your appointment:

To make the most of your first visit, please bring the following to your appointment:

New Patient History Form (see below for download)

Your driver’s license or other photo ID with a current address.

Your current health insurance card.

A list of your current medications.

All x-rays, MRIs or other imaging films.

Information about what treatments and medications you have tried in the past and any medical records that you think may be helpful.

List of questions you want to ask your physician.

Referral from your primary care physician, if applicable.

If the patient is a minor, a parent or guardian must bring the information listed above. Please be aware that if the requested information is not presented to our staff at the time of your appointment, we may have to reschedule your visit.

Your completed initial paperwork, using the “New Patient History form” link provided at the bottom of this page.

Please arrive 15 to 20 minutes prior to your first office visit to allow enough time to complete your registration.

If you are late for your appointment, you may be rescheduled as a courtesy to the other patients.

On your first visit

Your urologist will:

Discuss your symptoms with you. Depending upon your symptoms, your urologist may ask you how many times a day you have to urinate, whether you get up at night to go to the bathroom or whether or not you are experiencing any pain.

Review your records and previous tests.

Order more diagnostic tests.

Your urologist may also want to get a sense of how much the symptoms interfere with your daily life so that the two of you can discuss treatment options

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Patient Forms Needed

New Patient History Form

HIPAA Privacy Consent Form

HIPAA Notice of Privacy Practices

Scheduling appointments

All office visits are by appointment. When you call our office to arrange an appoint-
ment, our receptionist will make every effort to accommodate your scheduling
needs. If you have visited our office previously, please advise our receptionist regarding any changes in your name, address, telephone number or insurance coverage. For patients with urgent problems that require prompt attention, we try to schedule them in the same day.


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Many insurances require a referral and co-payment as part of their policies. We
require that you obtain your referral prior to your visit.


The co-payment is required at the time of your visit, so we may comply with the policies and regulations of your insurance.

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After hour emergencies

In case of an emergency, one of our eight surgeons is available 24 hours a day, 7
days a week. You can contact our office through our answering service at (781) 331-4600.

Routine matters, scheduling, test results, prescription refills, and billing questions are addressed during regular office hours only.

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Cancellation Policy

We request notification 24 hours in advance if you are unable to keep your scheduled appointment.

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Prescription Refill Policy

Prescription refills may be requested through the office Monday through Friday. It may require 48 hours for your prescription to be filled. However, pain medications will require an appointment as these cannot be refilled by phone.

We maintain privileges at South Shore Hospital, Quincy Medical Center.

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Medical Records Request

To process requests for medical records, South Shore Urology Associates needs either a signed form or letter.

Download and complete the Medical Records Request form and fax it to (781) 337-5095 or mail it to us.

You may send us a signed letter which includes the following information:

  • Name
  • Address
  • Date of Birth
  • Telephone Number
  • Purpose of the Request
  • Type of Information Requested
  • Where to Send the Medical Record
  • Signature

Send completed form or signed letter with a check for $15.00 to:

780 Main Street, Suite 2C
South Weymouth, MA 02190

You may also request your records in person.

Please allow sufficient time to process your request.

Form download link is below.

Patient Record Release Form