602-612-6947
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Center for Sexual & Urinary Function

Initial Office Visit

Schedule Appointment

The simplest way to schedule your appointment is to call 623-777-8353 during office hours, between 8 a.m. and 5 p.m. Monday to Friday. You can also request an appointment through this website. Once you become an established patient, you will have access to our Patient’s Portal. There, you can schedule your appointment online or communicate with us via secure email. You can also access your appointment summary, test results, request prescription refills or you electronic medical records. We will remind you about your scheduled appointment via e-mail, SMS messaging, and/or telephone calls 2 days before your appointment. Should you not be able to keep your appointment, please let us know at least 24 hours in advance!


What to Bring

Check list for your appointment:
1. Medical records or laboratory tests pertaining to the health issue you are going to discuss with the doctor
2. Diagnostic images (hard copies or computer disc) pertaining to your health issue
3. Government approved photo ID
4. Insurance card
5. Check, cash or credit card

You can download and complete the following forms and bring them with you to your first office visit. You will find additional questionnaires under male and female conditions.

Patient Info Sheet
DOWNLOAD

Comprehensive Health Symptoms Questionnaire (complete before printing)
DOWNLOAD

Female Medical History Questionnaire
DOWNLOAD

Male Medical History Questionnaire
DOWNLOAD

Medical History Female and Male
DOWNLOAD


Preparation for office visit

Your comprehensive urological evaluation will start with a medical history questionnaire and questionnaires pertinent to your problem. Additionally, you will be asked to complete a patient information sheet and sign financial policy forms. Please arrive 20 minutes before your actual office visit to allow time to complete your paper work. Or alternatively, you may download these forms from this website, print them, and complete them at home before your arrival. The questionnaires address issues regarding urinary or sexual function, and can help to establish your baseline function prior to treatment. You can download and print them from female or male patient section. They will be repeated after each treatment to document improvement. Your results will be tracked electronically on the flow sheet that is accessible through the patient’s portal. Please bring your current insurance card, plus cash, check or credit card if you self-pay or require copay.


Office Visit

As you arrive, you will be greeted by our receptionist. She is responsible for administrative tasks regarding your paperwork, scheduling, and financial matters. She is not trained to answer any of your medical questions. You will proceed to an examination room where our medical assistant will take your vital signs and review your completed questionnaires. Our medical assistant is able to answer basic questions regarding your urologic care. Next, Dr. Niemczyk ascertains your chief complaint, asks you pertinent questions, and listen to the details of the history of your illness. He then will conduct the appropriate urologic examination, including pelvic examination in females, and genital and rectal examination in males. Finally, Dr. Niemczyk will be able to discuss your diagnostic workup. Together, the doctor and you will decide upon a comprehensive treatment plan.


Check Out

Before you leave the examination room, requests for medical tests will be printed at the front desk, and necessary prescriptions will be emailed to your pharmacy or printed if required by DEA. You may receive additional explanations from MA regarding your home tasks or your home treatments. After each visit, you will obtain a summary of your visit that includes your next appointment and the receipt for payments. Your referring provider will receive a full report within in the same week.

Request A Consultation

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623-780-2300
Fax: 623-582-9666

Peter Niemczyk, MD, FACS
American Board of Urology
American Board of Anti-Aging/Regenerative Medicine

Glendale Office

Temporarily Closed. Patients will be seen at Phoenix Office.
Center for Sexual & Urinary Function
20325 N 51st Ave, Suite 102
Glendale AZ 85308
Phone: 602-612-6947

Phoenix

Center for Sexual & Urinary Function
9250 N 3rd Street, Suite 2007
Phoenix AZ 85020
Phone: 602-612-6947

Show Low Office

Center for Sexual & Urinary Function
5171 Cub Lake Rd.
Suite C-340

Show Low AZ 85901
Phone: 602-612-6947


Globe

Center for Sexual & Urinary Function
5886 S Hospital Dr. ,Building G
Globe AZ 85501
Phone: 602-612-6947

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