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Marin Sonoma Urology Associates

What to Bring to Your Appointment | Patient History Form
Payment and Insurance

What to Bring to Your Appointment

  • Your insurance card
  • Physician referral forms if required by insurance
  • A list of current prescription or over-the-counter medications you are taking, including dose and frequency
  • Pertinent information about your medical and surgical history
  • Any recent x-rays or appropriate records you may have

Patient History Form

You can view and/or print the 3 page patient history form by following the link below. [printable page troubleshooting]

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Payment and Insurance

Marin Sonoma Urology Associates is a provider for Medicare and most major insurance plans. We provide insurance billing. Anything not covered by insurance will be your responsibility.

We request payment at the time of your appointment for services that are not covered by insurance. Your insurance company may also require you to pay a copayment at the time of your appointment. When necessary, our staff will work closely with patients who require a payment plan.

If you have any questions regarding which insurance plans we accept or any patient billing concerns, please call us at the phone number below. Questions regarding your coverage and benefits should be directed to your employer or insurance company.

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Marin Sonoma Urology Associates
Peter N. Bretan, MD

1615 Hill Rd, Ste #11
Novato, CA 94947-4303
Tel: 415.892.0904
Fax:415.892.7134

Email: bretan.surgery@usa.net
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