Forms and Statements

Instructions for Forms

1. Please review our statements and policies below


2. All new patients please fill out the Maui Urology Intake form and the Patient Information form


3a. All men fill out the Male questionnaire (AUA-SHIM form)


3b. All women fill out the Female questionnaire form


You may bring these completed forms with you or send a copy in advance to expedite your visit.  If you choose to send a form by mail, we recommend keeping a copy to bring with, in case of mail transit failure.

image145

For patients seen previously at Maui Medical Group