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New Patients

We welcome new patients to our practice. Please contact our office to schedule a new patient appointment.  Have your insurance card and pharmacy address ready during this phone call, as we will need to enter this information when you schedule your appointment. 

For Your Office Visit

  • If your insurance requires a referral, you must request it from your child’s pediatrician.
  • Please bring your insurance card and co-pay.
  • We will collect your completed Patient History, Medication list, Financial Responsibility and HIPAA Review Confirmation forms.  If this is your first visit, you need to complete both pages of Patient History

For appropriate and thorough treatment of your child, please have all paperwork completed prior to your appointment.

  • If we requested you return a toileting diary, please have it completed and ready during your visit.  This is an essential component in the appropriate management of your child.
  • If your child is toilet trained and seeing us for a urinary problem, we will collect a urine sample at this visit.  Please have your child ready to void when you check-in.  

New Patient Forms

(Please complete both pages)

Patient Portal Access

Please note: The Patient Portal is to be used for Non-Emergent questions/concerns.


Pediatric Urology of Western New York

Phone

716-859-7978

Fax

716-844-5050

Cartoon lion icon10001 Main Street
Conventus Building
3rd Floor, Lion Clinic
Buffalo, New York 14203