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Locations:

  • Bedminster, NJ
  • Flemington, NJ
Hunterdon Urology Logo
  • ABOUT
    • Dr. Choi
    • Our Office
    • Patient Reviews
  • UROLOGICAL CONDITIONS
    • Symptoms & Conditions
    • Tests & Procedures
    • Minimally Invasive Surgeries
    • Vaginal Aesthetics
  • PATIENT INFO
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    • New Patient Registration
    • Post Op Info
  • NEWS
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  • CONTACT
    • Office Info
Call: 908-751-5939
Call: 908-751-5939
Hunterdon Urology Logo
  • ABOUT
    • Dr. Choi
    • Our Office
    • Patient Reviews
  • UROLOGICAL CONDITIONS
    • Symptoms & Conditions
    • Tests & Procedures
    • Minimally Invasive Surgeries
    • Vaginal Aesthetics
  • PATIENT INFO
    • Patient Forms
    • Patient Portal
    • New Patient Registration
    • Post Op Info
  • NEWS
    • Facebook & Twitter
  • CONTACT
    • Office Info

Locations:

  • Bedminster, NJ
  • Flemington, NJ

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  • ACKNOWLEDGE RECEIPT

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  • AUTHORIZATION FOR DISCLOSURE OF PHI

  • I hereby authorize Adult & Pediatric Urology of Hunterdon to verbally disclose my medical information, including but not limited to: lab test results, imaging test results, billing/claim/insurance information, making and confirming appointments with the following individuals:
  • I understand that I have the right to revoke this authorization, in writing, at any time by sending such written notification to the Privacy Officer at Adult & Pediatric Urology of Hunterdon to 5 Walter Foran Blvd, Suite 4001 Flemington, NJ 08822. I understand that a revocation is not effective to the extent that action has already been taken prior to date of notification. I understand that certain information cannot be released without specific authorization as required by state and federal law. By initialing the lines below I authorize the release of the following protected or sensitive information to the above named individuals:
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    Permission is hereby granted to healthcare providers within this practice to administer such testing, examinations, treatment and procedures as are deemed necessary in the course of my care. Information about me necessary to substantiate my insurance claims may be released by the healthcare provider involved in my care. I authorize payment directly to the provider's office of all insurance benefits otherwise payable to me for services rendered. I understand I am financially responsible for all charges whether or not paid by my insurance, for all services rendered on my behalf or on my dependents behalf.
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Contact Us

Please feel welcome to contact our office with any questions or concerns you may have about your care.

Flemington Location
5 Walter Foran Blvd, Suite 4001
Flemington, NJ 08822
Phone: (908) 751-5939

Bedminster Location
1590 Route 206 North
Bedminster, NJ 07921
Phone: (908) 751-5939

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Adult & Pediatric Urology of Hunterdon
  • 5 Walter Foran Blvd, Suite 4001 Flemington, NJ 08822
  • Phone: (908) 751-5939
  • Fax: (908) 751-5938
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Office Hours

The office is open Monday through Friday from 8:30AM until 4:30PM.




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