New Patient Introduction

Dear Patient,

Welcome to Commonwealth Urology, the office of Drs. John J. Basile and Sunil V. Patel. The doctors and staff here would like to thank you for choosing our practice to serve your urological needs. We take pride in our patients, and we will do our best to serve your needs.

Due to the nature of our practice, and the fact that Drs. Basile and Patel are surgeons, we occasionally have emergencies arise that will cause us to have to delay or reschedule your appointment. Please know that we always try to give you plenty of warning, whenever possible. There are several things that we request ahead of time to help make your first visit here go smoothly. Please bring the following items with you:

• Your insurance card (s)
• Any X-Rays (the actual film), lab results, and/or other pertinent reports
• A lists of current medications/allergies
• If required, a referral from your primary care doctor
• Be prepared to leave a urine sample at time of visit.

If your insurance plan requires a referral from your primary care doctor, please keep in mind that it is your responsibility to obtain the appropriate forms prior to your scheduled visit. It becomes very inconvenient at time of check-in when pertinent information is missing. If you do not have your referral, you will be held responsible for providing it to us in a timely manner, or you will be billed as if you were going outside of your provider plan.

If you have any questions or concerns, please call our office at 703.876.0288. Thank you and we look forward to seeing you soon!

Insurance and Payment Information

Drs. Basile and Patel are providers for Medicare and most major insurance plans, and provides insurance billing. You are responsible for charges that are not covered by your insurance, at the time of your appointment.

Your insurance company may require a co-payment at the time of your appointment. When necessary, our staff will work with patients 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.

Patient Forms and Instructions

You may be asked to complete and sign one or more of the following documents. You can view and/or print them before your appointment using the links below. Please bring completed forms to your appointment. Set printer to single page only to assist our processing of forms.

• New Patient Packet:
  • New Patient Packet - Adult Male Version (PDF)
  • New Patient Packet - Adult Female Version (PDF)
    [Printable PDF page help]

    These policies are part of the new patient packet but are provided here separately for your ease of reference in the future:

    • Patient Agreement (PDF)
    • Notice of Privacy Practices
    • No Show, No Call Policy (PDF)

• Consent to Surgery Form

• Policy for Cancellation of a Procedure

• Pre-Procedure Instructions

• Cystoscopy Info, Instructions, and Consent Form

• Kidney Stones Workup

• Exercise for Men with Urinary Leakage

• Vasectomy Info Packet and Forms

• Vasectomy Reversals Information

• Erectile Dysfunction - Treatment Info and Forms