Dr. Gholami California Urologist




Appointments & Contacts

We are happy to provide you with appointment resources to better process your paperwork and prepare you for your visit to our facility. To make an appointment you can contact us directly (408) 358-2030 or you can complete the online appointment request below. When we receive the online request you will be getting a call within 24 hours.
contacts and appointments

Lap Davinci Prostatectomy, Laparoscopic Urologic Surgery, Vasectomy, Laser Prostate Surgery
Office Information & Address

Urology Associates Of Silicon Valley
2460 Samaritan Drive
San Jose, CA 95124
408-358-2030

SCHEDULE YOUR APPOINTMENT ONLINE

Map & Directions

Hours: 9 a.m. to 5 p.m.
Most insurance plans accepted
Hospital privileges at all local facilities, including Good Samaritan Hospital of Los Gatos


Physicians & Assistant Office Extensions:

Contact Name

Assistant Name

Office Extention

Shahram Shawn Gholami, MD Ruby 408-596-5200 ext. 211
Surgery Scheduling June 408-358-2030 ext. 239
Billing Information ALN 1-866-637-7821

Lap Davinci Prostatectomy, Laparoscopic Urologic Surgery, Vasectomy, Laser Prostate Surgery
Schedule Your Appointment Online

Click here to request an appointment online >>


Lap Davinci Prostatectomy, Laparoscopic Urologic Surgery, Vasectomy, Laser Prostate Surgery
About Your Visit- Preparation

What to Bring to Your Appointment

Please bring with you the following:

  • Your insurance card
  • Physician referral forms
  • List of prescriptions and/or over-the-counter medication, including dose and frequency
    Information about your medical and surgical history
  • Recent x-rays or relevant record ( Please bring actual X-Rays if possible )
about your visit what to bring


Lap Davinci Prostatectomy, Laparoscopic Urologic Surgery, Vasectomy, Laser Prostate Surgery
Patient Forms

Please download, print and complete the following forms for preparation for your appointment.

 

Patient Office Forms

Patient Registration
Medical History Form
Privacy Notice
Financial Policy
HIPPA Policy
Fertility Policy



Pre-Post Operative Patient Instructions

TRANSURETHRAL INSTRUCTION SHEET
Da Vinci® PROSTECTOMY INSTRUCTIONS
PROSTATE RADIOFREQUENCY, PROSTATE MICROWAVE, TRANSURETHRAL RESECTION OF THE PROSTATE (TURP), TRANSURETHRAL RESECTION OF BLADDER TUMORS (TURBT)
HYDROCELE, SPEMATOCELE OR OTHER SCROTAL SURGERY
KIDNEY AND URETERAL STONE SURGERY
RADICAL ORCHIECTOMY, HERNIA SURGERY, VARICOCELE SURGERY OR OTHER GROIN SURGERIES
FEMALE INCONTINENCE SURGERY, CYSTOCELE SURGERY
PROSTATE BRACHYTHERAPY
OPEN RADICAL PROSTATECTOMY, ROBOTIC RADICAL PROSTATECTOMY
patient forms

Forms require Adobe Reader - click the Adobe icon below to download software for free.

Lap Davinci Prostatectomy, Laparoscopic Urologic Surgery, Vasectomy, Laser Prostate Surgery
Billing & Insurance

Our office contracts with most insurance companies. Your Insurance company provides you with proof of insurance that must be presented prior to all services. We bill all primary insurance plans for our patients. Payment for co-payments, deductibles, and payment for any non-covered service is required at the time of your visit. If you have no insurance, your account will be treated as a cash account and we will collect payment in full at the time of service. For your convenience we accept check, cash, Visa, and Master Card.

Your individual insurance plan is an agreement between you and your insurance company. It is necessary for you to know the specific details of your plan. If your plan requires a referral for specialty services, it is especially important to notify us if there are restrictions on referrals to outside facilities for services. It is your responsibility to arrange for all appropriate referrals and authorizations required for insurance payment. You will be liable for all charges billed for outside providers if they are not contracted with your plan and you have not received the proper pre-authorization. It is your responsibility to know if you referral has expired and to obtain a new referral if needed.

Download our Financial Policy

Lap Davinci Prostatectomy, Laparoscopic Urologic Surgery, Vasectomy, Laser Prostate Surgery
Office Directions

Directions from Highways 85 & 880

85 (driving No.): Take Bascom/Los Gatos Blvd exit. Turn left on Bascom, then left on Samaritan.
85 (driving So.): Take Los Gatos Blvd/Bascom exit. Turn right on Bascom, then left at Samaritan.
880 (driving So.): Take Lark exit. Turn left on Lark. Turn left at Los Gatos Blvd, then right at Samaritan.
880 (driving No.): Take Lark exit. Turn right on Lark. Turn left at Los Gatos Blvd, then right at Samaritan.
We recommend parking in the parking garage structure

 

Lap Davinci Prostatectomy, Laparoscopic Urologic Surgery, Vasectomy, Laser Prostate Surgery