Request Information on Clinical Trials

Here you can request more information on clinical trials conducted by the NYU Department of Urology. All information submitted via this web form is secure and confidential.

After you submit the form, a member of our research staff will follow up with you via e-mail or phone within 2 business days.

Please note, NYU Urology Associates highly respects your privacy. Contact information will NOT be shared or sold to any third parties under any circumstances.

Fields marked with an asterisk (*) are required.

Patient information
Contact information
Medical information
(Please check all that apply)
Please provide any additional information you would like us to have.