To get started: Call (888) 834-3095 to set up your appointment.

How to make the most of your consultation:

• Complete the forms and send them to us before your visit.
• Request medical records pertaining to your fertility be transferred here.
• The information you provide will allow our physicians to better understand your personal situation and fertility history.

You can save time by printing these forms.
We would also be happy to mail you the forms.

1. Form to complete and give to your doctor:  Please print out the following form. Fill it out and then return it to to your current physician or gynecologist by mail or fax.

1. Medical Records Request

2. Required forms to complete and return to PFC: Please print out the following forms. Fill them out and then return them to us here at PFC by mail, fax or by scanning them into your computer and emailing them to us at info@pacificfertility.com.

1. Registration Form
2. Female Patient History Form(s)
3. Male Patient History Form (if applicable)
4. Genetic Screening Form

Optional Forms:

1. Print Insurance Letter or check with your insurance company for coverage. Request an authorization if needed. Please be aware that we cannot book an appointment for HMO patients without prior authorization from your insurance medical group.
2. Print, Consult with your Referring MD re: Preliminary Testing (not mandatory) and if performed, include test results in Medical Records.

Fax:
(415) 834-3080