AUUA

Forms

New Patient Intake Forms

Male

Female

Hombres (en Espanol)

Mujeres (en Espanol)

Intake Form for Dr. Klauschie's Patients

Packet

Authorization for Release of Information

Authorization Form

Authorization to Release Healthcare Information Form

Authorization to Release Form

 

Call 623-547-2600

to schedule an appointment for a consultation with one of our Urologists and start restoring your
pelvic health today.