Patient Information

Payment and Insurance Information

Southeast Urology Network is a provider for most major insurance plans, and we do accept Medicare and most HMO and PPO plans. However, it is in your best interest to check your insurance providers list of participating physicians to be sure your plan allows you to be seen at our office. Also, please review with your insurance customer service representative (or insurance provider) the rules and limitations on coverage and reimbursement.

New Patient Forms

Here is our new patient enrollment form that you can view and print prior to your office visit.  Please complete and bring the completed form to your first visit.

As always, if you have any questions or comments please feel free to call either office at the numbers listed below.

What to Bring to Your Initial Appointment

On your initial office visit with us our receptionist will ask you to fill out a patient information sheet. Please be able to fill out the following list (all information is essential and will be handled with the strictest of confidence):

  • Insurance card
  • Referral form (if dictated by your insurance provider)
  • List of all medication including the dosage and frequency
  • Allergies
  • Surgeries
  • Primary care physician
  • Prior lab test pertinent to your current condition
  • Prior radiology test films and reports pertinent to your current condtion
  • Emergency contact
  • Home and work telephone numbers

If you would like to already have your paperwork filled out so that we may serve you more quickly please fill out and bring in this form on your visit.

Hospital Privileges

  • Baptist East
  • Baptist Desoto
  • Methodist Germantown
  • St. Francis East


80 Humphreys Center, Suite 310
Memphis, TN 38120

Phone: (901) 747-3370
Fax: (901) 747-3372

East Office - Memphis, TN

995 S. Yates - Suite 1
Memphis, TN 38119
Tel: 901.527.7100
Fax: 901.527.7124

Southaven, MS

7420 Guthrie Drive North - Suite 111
Southaven, MS 38671
Tel: 662.349.2220
Fax: 662.349.4414