Pacific Fertility Center

Complete PFC forms and return them PRIOR to your appointment.
Ensure the delivery of your fertility-based medical records to Pacific Fertility Center PRIOR to your appointment.
Information submitted prior to your appointment enables the doctor to gain a better understanding of your fertility history, allows them to address your specific situation and helps prevent unnecessary repeat testing.

WAYS TO COMPLETE YOUR FORMS:

Complete forms online and email to info@pacificfertility.com (see instructions below).
Fax completed forms to 415-834-3080.
Mail completed forms to:

PFC - NPG
55 Francisco Street, Suite 500
San Francisco, CA 94133

These forms require Adobe Acrobat Reader 8 to work correctly. To download Acrobat 8 for free, click the link or icon above.

B. MEDICAL RECORDS TRANSFER

Complete and fax to your CURRENT physician’s office ASAP.

C. PFC REQUIRED FORMS

Complete and send applicable forms to Pacific Fertility Center.

D. INFORMATIONAL DOCUMENTS FOR NEW PATIENTS:

E. OPTIONAL FORMS FOR CURRENT OR RECENT PATIENTS:

F. CONTACT INFORMATION:

Address:
New Patient Guides
Pacific Fertility Center
55 Francisco Street, Suite 500
San Francisco, CA 94133

Fax:
(415) 834-3080

Phone:
(888) 834-3095
(415) 834-3095

Current patients, please call (415) 834-3000

Form Instructions:

These forms require Adobe Acrobat Reader 8 to work correctly. To download Acrobat 8 for free, click the link or icon above.

Instructions for filling out these forms:

1. Open the forms in Adobe Acrobat Reader 8 and you can fill in the forms online. You can save, email and/or print the forms.

2. If you email the forms to us, depending on the setup of your system, you will usually be asked what type of email program you are using (e.g. a desktop application such as Outlook, or web email such as Hotmail or Yahoo Mail).

3. For each form we receive from you via e-mail, a receipt will be sent to the email address the form was submitted from. If you do not receive a receipt from us after submitting your form via e-mail, please call 1(888)834-3095.

4. If you wish to fill out the forms by hand, open the forms with Adobe Acrobat Reader 8, print the blank forms and and type or write your responses in black ink (it reproduces better). Then fax or mail the completed document(s) to us at the fax number and address listed above.