Departmental Forms

• Theatre Discharge Planning
• Bladder Cancer surveillance form
• Testis tumour referral form
• Consultant Annual Leave Form

LUTS

• IPSS Symptom Score - Click here

Cancer Forms

• Mitomycin Stat dose Revised Mar 11
• Mitomycin Induction Revised Mar 11
• BCG induction - Immucyst Revised Mar 11
• BCG Maintenance - Immucyst Revised Mar 11
• BCG Induction - Oncotice NEW
• Starting Antiandrogens
• Urgent Urology Referral / One Stop Haematuria Referral
• Proforma for referral to Penile SMDT
• Notification to GPs of new Cancer Diagnosis
• Bladder Cancer Risk Stratification New Aug 12

BAUS Consent Forms

• Adrenalectomy (radical)
• brachytherapy for CAP
• brachytherapy planning
• circumcision
• colposuspension
• cystectomy (radical) and ileal conduit (female)
• cystectomy (radical) and ileal conduit (male)
• cystectomy (radical) and neobladder (female)
• cystectomy (radical) and neobladder (male)
• cystoscopy and biopsy or stent removal
• cystoscopy and biopsy
• cystoscopy and biopsy - including consent for VE or DRENEW
• cystoscopy and bladder distension
• cystoscopy and clot evacuation
• cystoscopy and injection of bulking agent
• cystoscopy and removal of bladder stone
• cystoscopy and retrograde
• cystoscopy and stent
• cystoscopy and u/diln in men and biopsy if reqd
• cystoscopy and u/diln in women and biopsy if reqd
• cystoscopy and urethrotomy
• epididymal cyst excision
• eswl
• exploration of scrotum for suspected torsion
• freeing of preputial adhesions
• frenuloplasty
• herniotomy
• hydrocele repair
• hypospadias repair
• ileal conduit formation
• nephrectomy (partial)
• laparoscopic varicocele ligation
• laparoscopy (diagnostic)
• ligation of ppv (hydrocele repair)
• nephrectomy (radical)
• nephrectomy (simple)
• nephrolithotomy (open)
• nephroureterectomy
• nesbitts procedure
• orchidectomy (simple) +/- prosthesis insertion
• orchidectomy (radical) +/- prosthesis insertion
• orchidectomy (simple)
• orchidopexy
• parent consent form
• pcnl
• penile amputation (partial or complete)
• pyelolithotomy (open)
• pyeloplasty (open)
• pyeloplasty
• resection of posterior urethral valves
• retropubic prostatectomy (millins)
• spc insertion (cystotomy)
• testicular prosthesis insertion
• testis biopsy
• turbt
• Transrectal Ultrasound and biopsy of Prostate NEW
• turp (cancer)
• turp
• ureterolithotomy (open)
• ureterolysis for rpf
• ureteroscopy +/- biopsy
• ureteroscopy and stone removal
• vasectomy

Service Request Forms

• New Service Request Form
• Prior approval request form

Travel Claim Forms

• Travel Claim
• Extra Session Claim Form June 2010

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