Patient Registration Forms

In order to maximize your time during your first visit, we recommend that you print and complete the forms below prior to arrival. Please arrive 20 minutes before your scheduled appointment to allow time to complete the registration process.

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Your Telemedicine Consult – We have created an informative blog post with quick tips and a FAQ for optimizing your telemedicine consultation.

Optimizing your Telemedicine Consultation – Blog Post

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Step 1

Please complete the appropriate form:

• General Patient Health History (complete a copy for patient and partner, if applicable)
• Fertility Assessment Only

Step 2

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

• SRM Policies and Acknowledgement

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:

• Authorization Form to Release Medical Information to SRM

Step 4

Please review the following information:

• New Patient Appointment Checklist (recommended)
• Welcome to Seattle Reproductive Medicine
• Preconception Health
• Patient Rights and Responsibilities
• Project Journey Research Study