Request an Appointment at Urology Austin

Request an appointment at Urology Austin

This appointment request tool is intended for non-urgent appointments. After submitting your request, a Urology Austin staff member will contact you within 48 business hours to finalize your appointment.

IMPORTANT NOTE: Submitting a preferred date and time does not guarantee the appointment slot. The date and time slot will be confirmed when you are contacted by a patient service representative.

If you are experiencing a urological medical emergency, do not use this form. Instead, call 911 or go directly to an emergency room. You can also call any of our offices during regular business hours. Urological emergencies may include: acute pain from kidney stones, urinary retention (an inability to urinate), visible blood in the urine, and long-term erection.

"*" indicates required fields

Please enter your contact information:

Name*

First Last

Email*

Date of Birth*

Patient address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number*

Alternate Phone Number

Click the appropriate box:*

New Patient

Established patient

Insurance company name*

Insurance ID#*

Group ID#

Referring Provider or Primary Care Provider

When would you like your appointment?

Preferred date

Preferred time

Click box for First Available

Yes

Location preference

Provider Preference (Austin Central Office)

Provider Preference (Austin South Office #1)

Provider Preference (Austin South Office #2)

Provider Preference (Bastrop Office)

Provider Preference (Cedar Park Office)

Provider Preference (Dripping Springs Office)

Provider Preference (Far West Office)

Provider Preference (Georgetown Office)

Provider Preference (Jollyville Office)

Provider Preference (Kyle Office)

Provider Preference (LaGrange Office)

Provider Preference (Lakeway - Bee Caves Office)

Provider Preference (Lampasas Office)

Provider Preference (Lockhart Office)

Provider Preference (Luling Office)

Provider Preference (Marble Falls Office)

Provider Preference (Radam Lane Office)

Provider Preference (Round Rock Office #1)

Provider Preference (Round Rock Office #2)

Provider Preference (The Austin Center for Radiation Oncology)

Provider Preference (Westlake Office)

Click box for First Available Provider

Yes

Reason for your visit.*