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Patient Forms
New Patient Adult History Forms
New Patient Medical History & Information Form
New Patient AUA Symptom Index and Karnofsy Score
Formulario De Historial De Salud Para Adultos
Pediatric Forms
New Patient Pediatric Forms
Click here to download the following form: Request and Authorization for the Release of Medical Records
to Urology Clinics of North Texas
Click here to download the following form: Authorization for the Release of Medical Records
from North Texas Pediatric Urology Associates
David H. Ewalt, M.D., Vesicoureteral Reflux Handout
Click here to download a Patient Handout on Vesicoureteral Reflux, (VUR). A condition that affects approximately 1% of all children and is often associated with
Urinary tract infections (UTls). New window will open, 12MB PDF.
Patient Consent Forms
Consent to Photograph and Quote
Media Authorization for the
Use and Disclosure of Protected Health Information
About Urology Clinics of North Texas | Urology conditions treated at UCNT: prostate cancer, kidney cancer, ureteral cancer, bladder cancer, testicular cancer, kidney stones, enlarged prostate (benign prostatic hyperplasia), male and female incontinence, erectile dysfunction, female infertility, male infertility, voiding dysfunction, male and female urinary urgency and frequency | Technology and Robotic Surgery at Urology Clinics of North Texas, robotic prostatectomy, vasectomy | In the News | Patient Information | Contact Urology Clinics of North Texas | Location information for our urology offices in Dallas, Plano, Allen, Garland, Grapevine, Ennis, Rockwall
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