Am I Candidate for HIFU Prostate Cancer Therapy?


HIFU with the Sonablate® 500 has many proven advantages over traditional treatment modalitites for prostate cancer. To find out if you qualify please email our medical team.

Please make sure you provide a good description of your medical history including:
  • Recent PSA
  • Prostate Cancer Gleason Score
  • Prostate size/volume
  • Treatment strategy thus far
  • Any other relevant medical information

Or call our prostate cancer hotline at 1-336-227-2761 to speak with Dr. Michael Wolff.

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GENERAL CONTACT INFORMATION
* First Name:  
* Last Name:  
* Email Address:  
Address:
City:
State:
Zip Code:
* Phone:  
Best time to call:
Fax:
How did you find the site:
PATIENT INFORMATION
Date of Birth:  (e.g., 05/02/1965)
Have you been diagnosed with prostate cancer:
If "Yes", please complete the following: 
When were you diagnosed:  (e.g., 05/02/2008)

Have you had previous treatment for prostate cancer?
(check all that apply):

 
 
 
 
 
* What was your PSA at the time of the diagnosis:
Current PSA & PSA History:
What was your highest Gleason score:
What was the date of your biopsy:  (e.g., 05/02/2008)
Size of Prostate (in grams):
Have you experienced recurrence:
Comments/Questions:
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