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Patient Information


























Tri City Urology



What to Bring to Your Appointment   
Insurance and Payment Information
Hospital/Facility Affiliations
Patient Forms, Information Sheets, & Instructions

What to Bring to Your Appointment

  • Your insurance card
  • Physician referral forms if required by insurance
  • A list of current prescriptions and/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
  • Any recent blood work results

Insurance and Payment Information

Tri City Urology 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 co-payment 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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Hospital/Facility Affiliations

  • Bay Medical Regional Center
  • Covenant HealthCare
  • Saint Mary's Medical Center

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Patient Forms, Information Sheets, & Instructions

We are pleased to offer you the opportunity to print our forms, information sheets, and patient instructions at your convenience from this website.

To print these materials you must have the Adobe Acrobat Reader on your computer. Download this program free of charge by clicking on the Get Acrobat Reader button. Follow the on-screen instructions, and the download will take just a few minutes to complete. If you already have the Adobe Acrobat Reader, simply click on the item you want to view and print.

Patient forms

Instructions Information
[printable page troubleshooting]

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Refer a Friend

Tri City Urology

Saginaw
 1117 S. Washington Avenue
Saginaw, MI 48601
Tel: 989.791.4020
Fax: 989.791.5152
click here for a map
Bay City
 4 Columbus Ave
Bay City, MI 48708
Suite 130
Tel: 989.895.2634
Fax: 989.895.2636
click here for map
West Branch Regional Medical Center
 2463 S M-30
West Branch, MI 48661 
Tel: 989.791.4020
fax 989.791.5152
click here for map
Frankenmuth
 600 Main Street 
Suite 230 
Frankenmuth, MI 48734
Tel: 989.791.4020 
click here for map
Mt Pleasant
 211 S. Crapo 
Suite B
Mt Pleasant, MI 48858
Tel: 989.791.4020 
Fax: 989.791.5152 
click here for map
Gladwin
 609 Quarter St 
Gladwin, MI 48624
Tel: 989.895.2634 
click here for map
Bad Axe
 1060 S Van Dyke
Bad Axe, MI 48413
Tel: 989.269.6651 or
Tel: 989.269.9521 ext 4741
click here for map