You will be asked to complete a set of forms prior to your first visit. Some of these will cover necessary formalities such as demographic, contact and insurance information, certain legal notices, office policies, etc. The rest will obtain clinically relevant information from you, including certain questionnaires, scales or inventories that are meant to be filled out on your own in order to assist and guide the assessment process during your visit. Completion of these forms typically takes at least one hour, and may take up to 90 minutes. You should bring with you a complete list of any medications, supplements, etc. you may be currently using. You may also bring any previous medical records, such as laboratory or test reports, if available. Any other instruction that Dr. Duzyurek may give in preparation to your visit will be covered during your initial phone contact.
Some new patients opt to arrive 75 minutes in advance of their appointment time and complete a personalized package of new patient forms in the office before they are seen. However, other patients prefer to complete these forms at home before their appointment. If you prefer the latter, you can find most (but not necessarily all) of the forms you will need below in pdf format. Please note, you will need to download, open and print out ALL of the forms, fill them out using a pen, and importantly, remember to bring all of the completed forms with you to your appointment. Please also note that with this option, you are still asked to arrive at least 15 minutes before your scheduled appointment time, as you may need additional time for forms that you have not downloaded. Also, arriving early allows for a stabilization of your vital signs, such as blood pressure, for an accurate initial measurement.
NEW PATIENT FORMS and PREPARATION FOR YOUR VISIT
MALE SEXUAL FUNCTION HEALTH Practice
SINAN DUZYUREK, MD, PLLC - Washington, DC
The Core Package (required for all patients)
Some of the commonly utilized add-on forms (on a case-by-case basis)
All patients need the first 6 forms, and some may also need the form # 7.
- In order to download, please click on each form below separately -
Please note there is some degree of overlap or redundancy among some of the forms. Please do answer all questions on all forms, and staple together the pages of a given form. If there is an item that you are not sure how to respond to, you can mark it for asking Dr. Duzyurek about it during your appointment.