Atlanta Center for Laparoscopic Urogynecology
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Please complete Section I and II of your patient packet PRIOR to your appointment. We must receive your completed paperwork within 48 hours of your scheduled appointment time. Upon completion of your packet, the results will be emailed to our confidential nurses email address. You can also indicate an email address where you will receive a copy as well. Once you start the packet, you cannot save and come back, so please be prepared to complete all sections at one time.
SECTION I, SECTION II, AND SECTION III MUST EACH BE E-SIGNED ONLINE - IF COMPLETED PROPERLY, YOU WILL RECEIVE THREE (3) SEPARATE CONFIRMATION EMAILS.
Dr. Miklos and Dr. Moore are leading surgeons in their field of expertise and take great pride in providing you quality and confidential care. Patients are highly valued and provided with extensive consultation time with the physician. Your appointment time is reserved for you alone and therefore failure to arrive at your scheduled time with your paperwork complete, creates a hardship for the practice and patients scheduled after you. Late arrival or incomplete paperwork may result in the need for our office to reschedule your appointment for another day and time.
Section III is a Bladder Diary. This, too, is very important for Dr. Miklos and Dr. Moore to make a complete diagnosis. We ask that you complete this and bring it with you to your appointment. The frequency volume chart should be for at least a 72-hour period, prior to your first appointment with the doctor. This is best done over the weekend when you do not have to have the everyday stresses' of work and/or activities. The amount of intake and amount voided do not have to be exact measurements and they can be listed either in cc's or ounces, using any type of measuring container. This information is very helpful to us regarding.
We are looking forward to meeting you!!!!!!
John R Miklos, MD
Robert D Moore, DO
Online New Patient Packet Sections
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Patient Packet
