Patrick Culligan, MD, FACOG, FACS Urogynecologist NYC

Opening Hours : Monday - Friday | 8 am - 4 pm
  Contact : 212-746-4600

New Patient Information

New Patient Packet

In order to provide you with the best possible care, we would like to ask you to read this sheet and complete the linked forms prior to your first visit. Each form is described below. Please click on the link below, print out the formscomplete them and bring these forms with you to your first visit. PLEASE DO NOT MAIL THESE FORMS.

  1. New Patient Packet
  2. Contact, Referral and Consult Request forms
  3. Please do not forget the bladder diary sheet (page 8 of the patient information packet). A standard one cup measuring device may be used to measure volume in ounces or milliliters. We do not want you to save your urine, it should be discarded after recording each voided amount.
  4. Please bring a current medication list or your medicine bottles to the first visit.
  5. Please bring old medical records, operative reports, and/or urine cultures that might be pertinent to your condition.
  6. In the event of a need to cancel or reschedule your appointment, please call us at 212-746-4600 as soon as possible.
  7. Please bring your insurance card(s) when you come to our office.