Patient Registration Forms

Please download, print, and complete the necessary registration forms linked below and upload to your patient portal. It is important that your provider have all your information prior to your telemedicine visit.

We have created an informative blog post with quick tips and a FAQ for optimizing your consultation.

Step 1

Please complete the appropriate form:

Step 2

Please read and sign the last three pages of the Policies and Acknowledgements Packet. Print one packet for each partner (if applicable):

Step 3

Please print and sign the Release Form if you have relevant outside medical records. These would include any prior fertility testing or treatment, or any other labs done within the past year: