{"id":2001,"date":"2026-08-25T13:05:22","date_gmt":"2026-08-25T11:05:22","guid":{"rendered":"https:\/\/gautengurologie.co.za\/WP0826\/?post_type=patient-zone&#038;p=2001"},"modified":"2026-10-15T14:47:25","modified_gmt":"2026-10-15T12:47:25","slug":"patient-medical-information-forms","status":"publish","type":"patient-zone","link":"https:\/\/gautengurologie.co.za\/WP0826\/patient-zone\/patient-medical-information-forms\/","title":{"rendered":"Patient &amp; Medical Information Forms"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"2001\" class=\"elementor elementor-2001\">\n\t\t\t\t<div class=\"elementor-element elementor-element-56008414 e-flex e-con-boxed wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-parent\" data-id=\"56008414\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-396fd346 elementor-widget elementor-widget-xpro-page-title\" data-id=\"396fd346\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"xpro-page-title.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\n<h1 class=\"xpro-page-title\">\n<span class=\"xpro-page-title-text\">\n\t\tPatient &amp; Medical Information Forms\t<\/span>\n<\/h1>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1832f2b9 e-flex e-con-boxed wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-parent\" data-id=\"1832f2b9\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-1b6e085b e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no elementor-invisible e-con e-child\" data-id=\"1b6e085b\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;animation&quot;:&quot;slideInUp&quot;,&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2bec748c elementor-widget elementor-widget-text-editor\" data-id=\"2bec748c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4>Download and fill in the necessary form\/s, email it back to us or print it and bring it along to your appointment<\/h4>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-82e1634 elementor-align-left elementor-widget elementor-widget-elementskit-page-list\" data-id=\"82e1634\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"elementskit-page-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"ekit-wid-con\" >\t\t<div class=\"elementor-icon-list-itemsfg \">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-list-item   \">\n\t\t\t\t\t\t<a class=\"elementor-repeater-item-3e85b2a ekit_badge_left\" href=\"https:\/\/gautengurologie.co.za\/WP0826\/wp-content\/uploads\/2026\/08\/Patient_Information_form.pdf\" target=\"_blank\">\n\t\t\t\t\t\t\t<div class=\"ekit_page_list_content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">\n\t\t\t\t\t\t\t\t\t<span class=\"ekit_page_list_title_title\">Patient information form<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-icon-list-item   \">\n\t\t\t\t\t\t<a class=\"elementor-repeater-item-f963367 ekit_badge_left\" href=\"https:\/\/gautengurologie.co.za\/WP0826\/wp-content\/uploads\/2026\/08\/GAUTENGUROLOGY-MedicalQuestionare2022.pdf\" target=\"_blank\">\n\t\t\t\t\t\t\t<div class=\"ekit_page_list_content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">\n\t\t\t\t\t\t\t\t\t<span class=\"ekit_page_list_title_title\">Medical history form<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-icon-list-item   \">\n\t\t\t\t\t\t<a class=\"elementor-repeater-item-4855f28 ekit_badge_left\" href=\"https:\/\/gautengurologie.co.za\/WP0826\/wp-content\/uploads\/2026\/08\/International_Prostate_Symptom_Score_I-PSS-2022.pdf\" target=\"_blank\">\n\t\t\t\t\t\t\t<div class=\"ekit_page_list_content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">\n\t\t\t\t\t\t\t\t\t<span class=\"ekit_page_list_title_title\">IPSS form<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-icon-list-item   \">\n\t\t\t\t\t\t<a class=\"elementor-repeater-item-14aef78 ekit_badge_left\" href=\"https:\/\/gautengurologie.co.za\/WP0826\/wp-content\/uploads\/2026\/08\/Sexual-Health-Inventory-For-Men-SHIM-2022.pdf\" target=\"_blank\">\n\t\t\t\t\t\t\t<div class=\"ekit_page_list_content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">\n\t\t\t\t\t\t\t\t\t<span class=\"ekit_page_list_title_title\">SHIM form<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-icon-list-item   \">\n\t\t\t\t\t\t<a class=\"elementor-repeater-item-34ac491 ekit_badge_left\" href=\"https:\/\/gautengurologie.co.za\/WP0826\/wp-content\/uploads\/2026\/08\/Gauteng_Urology_BILLING_POLICY_2022.pdf\" target=\"_blank\">\n\t\t\t\t\t\t\t<div class=\"ekit_page_list_content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">\n\t\t\t\t\t\t\t\t\t<span class=\"ekit_page_list_title_title\">Billing Policy<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t<\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d1b9bfd e-con-full elementor-hidden-mobile e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-child\" data-id=\"d1b9bfd\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;shape_divider_bottom&quot;:&quot;opacity-tilt&quot;}\">\n\t\t\t\t<div class=\"elementor-shape elementor-shape-bottom\" aria-hidden=\"true\" data-negative=\"false\">\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 2600 131.1\" preserveAspectRatio=\"none\">\n\t<path class=\"elementor-shape-fill\" d=\"M0 0L2600 0 2600 69.1 0 0z\"\/>\n\t<path class=\"elementor-shape-fill\" style=\"opacity:0.5\" d=\"M0 0L2600 0 2600 69.1 0 69.1z\"\/>\n\t<path class=\"elementor-shape-fill\" style=\"opacity:0.25\" d=\"M2600 0L0 0 0 130.1 2600 69.1z\"\/>\n<\/svg>\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-22f1806 elementor-widget elementor-widget-heading\" data-id=\"22f1806\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Patient Zone<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fdd942f wpr-page-list-vertical wpr-pl-badge-center wpr-pl-icon-center elementor-widget elementor-widget-wpr-page-list\" data-id=\"fdd942f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wpr-page-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wpr-page-list-wrap\"><ul class=\"wpr-page-list\"><li class=\"wpr-page-list-item elementor-repeater-item-ef835a0 wpr-pointer-none wpr-pointer-line-fx wpr-pointer-fx-fade\"><div><a  href=\"https:\/\/gautengurologie.co.za\/WP0826\/patient-zone\/about-your-visit\/\" class=\"wpr-no-pointer wpr-pl-title\">About your visit <\/a><\/div><\/li><li class=\"wpr-page-list-item elementor-repeater-item-6838bc1 wpr-pointer-none wpr-pointer-line-fx wpr-pointer-fx-fade\"><div><a  href=\"https:\/\/gautengurologie.co.za\/WP0826\/patient-zone\/patient-medical-information-forms\/\" class=\"wpr-no-pointer wpr-pl-title\">Patient & medical information forms <\/a><\/div><\/li><li class=\"wpr-page-list-item elementor-repeater-item-f450722 wpr-pointer-none wpr-pointer-line-fx wpr-pointer-fx-fade\"><div><a  href=\"https:\/\/gautengurologie.co.za\/WP0826\/patient-zone\/patient-practice-contract-forms\/\" class=\"wpr-no-pointer wpr-pl-title\">Patient Practice Contract Forms<\/a><\/div><\/li><li class=\"wpr-page-list-item elementor-repeater-item-e72effa wpr-pointer-none wpr-pointer-line-fx wpr-pointer-fx-fade\"><div><a  href=\"https:\/\/gautengurologie.co.za\/WP0826\/patient-zone\/procedure-information-consent-forms\/\" class=\"wpr-no-pointer wpr-pl-title\">Procedure information & consent forms <\/a><\/div><\/li><li class=\"wpr-page-list-item elementor-repeater-item-4c60f60 wpr-pointer-none wpr-pointer-line-fx wpr-pointer-fx-fade\"><div><a  href=\"https:\/\/gautengurologie.co.za\/WP0826\/patient-zone\/before-your-surgery\/\" class=\"wpr-no-pointer wpr-pl-title\">Before Your Surgery<\/a><\/div><\/li><li class=\"wpr-page-list-item elementor-repeater-item-9b63b06 wpr-pointer-none wpr-pointer-line-fx wpr-pointer-fx-fade\"><div><a  href=\"https:\/\/gautengurologie.co.za\/WP0826\/patient-zone\/anesthetists\/\" class=\"wpr-no-pointer wpr-pl-title\">Anesthetists<\/a><\/div><\/li><li class=\"wpr-page-list-item elementor-repeater-item-c62aaf9 wpr-pointer-none wpr-pointer-line-fx wpr-pointer-fx-fade\"><div><a  href=\"https:\/\/gautengurologie.co.za\/WP0826\/patient-zone\/physiotherapy\/\" class=\"wpr-no-pointer wpr-pl-title\">Pelvicsense Physiotherapy<\/a><\/div><\/li><li class=\"wpr-page-list-item elementor-repeater-item-8c9d2b7 wpr-pointer-none wpr-pointer-line-fx wpr-pointer-fx-fade\"><div><a  href=\"https:\/\/gautengurologie.co.za\/WP0826\/patient-zone\/raath-spies-physiotherapists\/\" class=\"wpr-no-pointer wpr-pl-title\">Raath & Spies Physiotherapists<\/a><\/div><\/li><li class=\"wpr-page-list-item elementor-repeater-item-d9cd5a1 wpr-pointer-none wpr-pointer-line-fx wpr-pointer-fx-fade\"><div><a  href=\"https:\/\/gautengurologie.co.za\/WP0826\/patient-zone\/billing-policy\/\" class=\"wpr-no-pointer wpr-pl-title\">Billing Policy<\/a><\/div><\/li><\/ul><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"featured_media":1988,"template":"","class_list":["post-2001","patient-zone","type-patient-zone","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/gautengurologie.co.za\/WP0826\/wp-json\/wp\/v2\/patient-zone\/2001","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/gautengurologie.co.za\/WP0826\/wp-json\/wp\/v2\/patient-zone"}],"about":[{"href":"https:\/\/gautengurologie.co.za\/WP0826\/wp-json\/wp\/v2\/types\/patient-zone"}],"version-history":[{"count":19,"href":"https:\/\/gautengurologie.co.za\/WP0826\/wp-json\/wp\/v2\/patient-zone\/2001\/revisions"}],"predecessor-version":[{"id":2472,"href":"https:\/\/gautengurologie.co.za\/WP0826\/wp-json\/wp\/v2\/patient-zone\/2001\/revisions\/2472"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/gautengurologie.co.za\/WP0826\/wp-json\/wp\/v2\/media\/1988"}],"wp:attachment":[{"href":"https:\/\/gautengurologie.co.za\/WP0826\/wp-json\/wp\/v2\/media?parent=2001"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}