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Forms/Information Sheets

Forms and Information Sheets

• New Patient History
• Practice Brochure
• Patient Navigation-Flow Sheet
• Instructions for Semen Collection
• Glucophage (metformin) fact sheet
   
• Medications
• PFC Patient Medication Coverage Questionnaire for IVF (6-2010)
• PFC Patient Medication Coverage Questionnaire for Gonadtropins  (6-2010)
• 
  Medical Records Release
• Instructions for LH predictor kits
• Femara Fact Sheet
• Clomid Fact Sheet  
• Consent form for methotrexate treatment 
• Consent for endometrial biopsy 
• Consent to hysterosalpingogram (HSG) 
• Consent to receipt of donor frozen sperm samples
• Consent to sonohysterography
• Informed consent for intrauterine insemination (IUI)
• Consent to transfer of cryopreserved embryos
• Consent to "transfer in", "storage", of cryopreserved materials
• Couples Consent for IUI
• Consent for IUI- Single Women
• Information and consent to the use of gonadotropins for ovulation induction
• Couples Consent to participate in the In Vitro Fertilization-Embryo Transfer Program
• Single female consent to participate in the In Vitro Fertilization-embryo transfer program
• In Vitro Fertilization, IVF, Patient Booklet
  In Vitro Fertilization, IVF, Patient Information
• PFC Initial Financial Info Letter 
• Couple Consent to Intrauterine Insemination PFC
• Gonadotropin Consent PFC