Patient Forms

Patient Forms

Welcome to our practice! We look forward to caring for you in the future. Prior to your initial visit to Fertility Answers we may ask you to complete our Patient Portal. This will help us be more efficient with your time and enable us to concentrate on establishing a diagnosis and treatment plan for you and your partner.

For efficiency, we ask that you bring to your appointment any gynecology, obstetrical, and/or hormone medical records from your past that you feel may be pertinent. Thank you very much and we look forward to meeting you!   If you are unable to complete forms online prior to your appointment, please plan to arrive 1 hour before your scheduled appointment time.

Online Patient Portal: Our Patient Portal is your link to our electronic medical records. Here you will be able to submit your medical history, check lab results, email your doctor or nurse and check financial information. All of our patients use our Patient Portal, regardless of location or whether you are seeing us for infertility, gynecology or tubal reversal.

  • Established Patients:  Enter your unique user ID and password to access your medical records through our Patient Portal. If you have forgotten your username and password, please call (888) 467-2229.
  • New Patients:  If you are interested in becoming a patient at Fertility Answers, please go to our Patient Portal and click on the link for New Patients. Your information and request will be reviewed by our medical staff and a response along with your unique User ID and Password will be e-mailed to you, generally within 24 hours.

 

Medical Records Release Forms

Patient Confidentiality (HIPAA) Forms: At Fertility Answers your medical information privacy is our number one concern. Rest assured that all of your medical records are considered confidential information. Our state-of-the-art electronic medical records and patient information system complies with all HIPAA (Health Insurance Portability and Accountability Act of 1996) requirements. Upon becoming a patient at Fertility Answers, you will be required to read and sign the following forms that comply with federal HIPAA laws. On occasion, we may also ask you to update your consent and authorization.

Other Practice Forms: