Welcome to
Hypospadias Specialty Center:
PATIENT FORMS
Drs. Nicol Bush & Warren Snodgrass, Specializing in Hypospadias Surgery from infants to adults
If you are a patient with Hypospadias Specialty Center, you may complete your required patient forms here.
Forms submitted through our online e-forms portal are HIPAA compliant and can be completed on your personal device. Please complete only the forms instructed by our office staff. If you have any questions, please contact our office.
PATIENT FORMS
New Patient Information
If you are a new patient, please complete this form for your patient registration.
OFFICE POLICIES
If you are a new patient, please complete this form to be added to your patient chart.
RECORDS REQUEST
If you are a patient and are requesting medical records, please complete this form.
POST OPERATIVE UPDATE
If you have had surgery at Hypospadias Specialty Center and have been instructed to provide a post-operative update, please complete this form.
SHIM QUESTIONNAIRE
If you are a patient at Hypospadias Surgery Center and have been instructed to complete the SHIM Questionnaire, please complete this form.
THERAPIST CONSENT
If you are a patient at Hypospadias Surgery Center and have been instructed to complete the consent form for therapist, Kyle Tillson, LPC, please complete this form.
FMLA REQUEST
If you are a patient at Hypospadias Specialty Center and have been instructed to complete the FLMA Request Form, please complete this form.
OPERATION HAPPENIS
If you are a patient at Parc Urology or Hypospadias and would like to share your name with Operation Happenis, please complete this form.
MEDICAL HISTORY
If you are a patient at Hypospadias Specialty Center and have been instructed to complete your Medical History form, please complete this form.