Patient Resources

New Patient Forms

Save your time! Please print and complete the New Patient Form
and bring it completed to your first appointment.


We are pleased to have a current relationship with the following insurance companies:

  • Altius
  • Aetna
  • Blue Cross/Blue Shield
  • Cigna
  • Deseret Healthcare
  • EMIA
  • First Health
  • Humana
  • IHC/SelectHealth
  • SelectHealth Advantage
  • PEHP
  • United Health Care
  • Medicare
  • Most other HMO and PPO plans

Even if your insurance company is mentioned in the list above above it is important to note that there are some exceptions.  Ultimately, it is your responsibility to ensure that your Granger Medical Summit Urology provider is covered by your insurance company.  We look forward to seeing you soon!



Granger Medical Summit Urology has a current relationship with the following hospitals:

  • Alta View Hospital
  • Intermountain Medical Center (IMC)
  • Jordan Valley Medical Center
  • Jordan Valley Medical Center – West
  • Lakeview Hospital
  • LDS Hospital
  • Lone Peak Hospital
  • Mountain Point Medical Center
  • Riverton Hospital
  • Salt Lake Regional Hospital and Medical Center
  • St. Mark’s Hospital

If your medical facility is not listed, please ask.


What to Bring

Prior to coming to one of our locations, keep in mind that it will expedite your visit/appointment if you bring the following items with you:

  • Referral, if required
  • Your Driver’s License
  • Your insurance card
  • Co-payment/deductible if required
  • List of current prescription or over-the-counter medications (please include dosage/frequency)
  • Pertinent information about your medical and surgical history
  • Any related x-rays or records
  • Completed forms from this website or that our office may have sent



© 2019 - Summit Urology Group is a division of Granger Medical Clinic