Medical History form
You can begin solving your urogenital problems by completing our optional Medical History form.
The Sava Perovic Surgical Team, led by Dr Rados Djinovic, needs detailed, accurate, complete information in order to do a long-distance evaluation before you travel to Belgrade.
Your information is confidential and read by only by Dr Djinovic and the case manager patient advocate.
Cost of the surgical solution for your urogenital problem depends on your medical history (such as relevant previous surgeries) and personal details, such as gender, age, height, weight, BMI.
You can provide that information in an email or the ONline Medical History Form below. But perhaps the easiest way to provide complete information is download our OFFline Medical History Form in plain text format and send it back to us an email attachment.
The form will open in a new window of your browser.
Do NOT complete the form in your browser. Instead:
- click the browser menu category FILE at the top of the page, then
- click on SAVE PAGE AS in the dropdown menu, then
- click on the SAVE button.
(The form will be saved in the folder of your computer or other viewing device you have set for browser downloads.)
- Complete the form using any text editor on any device.
- Send the completed form to us as an email attachment.
Here is a compressed (zipped) version of the form: Compressed OFFline Medical History Form. It may be easier to download for some viewing devices.
The surgeon needs
- penile implant surgery for fixing erectile dysfunction & male impotence;
- hypospadias repair;
- Peyronie's disease surgery;
- penis enlargement surgery;
- epispadias repair;
- bladder exstrophy repair;
- M2F Male to Female Transformation;
- bent penis surgery;
- correction of iatrogenic injury urology problems;
- pediatric congenital defects; as well as
- anomalies and syndromes, including urinary incontinence.
Information about the types of photos needed and how to send pics, radiation imaging, medical document imaging and psychiatric evaluations to us is explained on our page about that.
Avoid sending photos by email attachment whenever possible. Instead, read our article “How to Send Medical Photos” to learn how to send document scans, photos or medical imaging to Dr Djinovic securely and reliably
Our goal is to acknowledge we have received your medical history or email message within 24-48 hours. If your contact us on the weekend, a response may take longer.
Put our email address on your White List or Friends List or Buddies List or Approved Senders List to ensure our messages reach you.
Yahoo, Mail.RU, Mail.BG, AOL, Hotmail, Live, and Outlook are often prudish and heavy-handed censors.
They dislike urogenital topics such as like “sex” or “penis” or “vagina”.
We often link to relevant articles in our messages to patients. Those free email service providers dislike links in email.
Gmail does NOT censor incoming mail much. It is the best free email service in that regard.
If you do NOT get an answer from us within a reasonable period of time (approximately 72 hours), it is possible (likely) mail filters of your ISP or webmail provider or email program has blocked our response.
Check your junk folders or spam folders or bulk folders.
Evaluations, comments and answers from Dr Djinovic will take 1-7 weeks. In very busy periods, it has taken him up to 68 days to review certain complex cases.
Providing everything the surgeon needs to diagnose your case ensures you get the response you need in the shortest possible time and the fewest number of reviews.
Do your due diligence to enable yourself to be able to sign the Informed Consent Form prior to surgery.
Read carefully what we have already published about your health problem and our surgical solution for it.
Our articles are usually very condensed and concise with a lot of information that requires careful study and several reads to understand it all.
Online Medical History Form
- Monday - Friday 9 am to 5 pm
- Saturday & Sunday — Closed