Practice Resources
Update Our Records
This form can be used by paid subscribers to tell us about corrections or additions that we should make to your PMN record.
Name of Practice:
Practice Manager, Administrator or Office Manager:
AUA ID:
Name:
Title:
Primary Address and Contact Info. (preferred address of Practice Manager)
Address:
City:
State:
Zip Code:
Office Phone:
Office Fax:
E-mail:
(add your e-mail and we will subscribe you to our new listserv!)
Please provide the names of all practicing physicians in your office. If they are AUA members, please provide their AUA member I.D. number(s).
ID Number:
Update to address and/or phone information:
Yes No
Adding a Doctor:
Deleting a Doctor:
Adding a Practice Manager:
Deleting a Practice Manager:
Thank you!
