Please choose the appropriate form(s) below to assist us in getting to know you. They will open a PDF file. Please print and complete. You are welcome to fax in the forms at 952-820-3080 prior to your first visit. Please bring in any information that may help us to know your condition, such as medical test results, previous infertility treatments summary, etc.
Patient’s Health History Forms
- Health History Questionnaire (6 pages): ALL patients must complete these forms prior to their first visit.
- Fertility History and Information (3 pages): Each patient along with their partner seeking fertility care needs to complete, sign and date these forms.
Health Insurance/ Claim Information Forms
Please complete the appropriate form in addition to the Health History Forms if insurance billing is going to be used.