Forms and Questionnaires for New Patients

Appointments and Referrals

Call us at 401-793-4636 (4MEN)
for more information about our services, or to make an appointment, or refer a patient.

Monday to Friday
8 a.m. to 4:30 p.m.


The Men's Health Center
180 Corliss Street
Providence, RI 02904

Directions >>

Print, fill out and bring these forms in for your first appointment at the Men's Health Center. All forms below are in PDF format.

For All Patients

For New Patients Who Have Not Had Prostate Surgery

For New Patients Who Have Had Prostate Surgery