E-mail Us | Maple Grove, MN
Phone: 763.494.7700 | Toll Free: 800.508.9763

 

Facebook Linked In

About Us Getting Started General Infertility IVF Donor Programs Financial Locations

Getting Started, Fertility Treatment, Infertility Services in Maple Grove, MN
 

The First
Appointment

Schedule an
Appointment

New Patient
Forms

HIPAA Policies

 Home

New Patient Forms

We find that your personal knowledge of your medical history is of great value as we help you develop your treatment plan. With this in mind, we have developed a number of tools which will help you recall important aspects of your medical history.

Completion of the New Patient Forms is perhaps the most important first step. Once you have booked your appointment, please download these forms via Adobe Reader and e-mail them using our secure e-mail two weeks prior to your scheduled consultation. By allowing us to receive this important information well in advance of your appointment, we can better plan for your consultation, making the best use of your time.

New Patient Forms - Printable Version

Insurance Benefits Verification Form - (Print Only) Copy of insurance card must be attached for verification

New Patient Forms - (Online Only) For female patients with a male spouse/partner

Single New Patient Forms - (Online Only) For single patients

Same Sex Couples New Patient Forms - (Online Only) For female patients with a female spouse/partner

**These are electronic forms. Please fill out the appropriate forms, save to your computer and email them to our secure e-mail.  You will need Adobe Reader to complete these forms. Please note that you must create an electronic signature or your forms will not save.

Please remember to complete and return the New Patient Forms two weeks prior to your first appointment.

It is our practice to carefully review your New Patient Forms and to use this information as a basis for a phone visit with one of our staff prior to your new patient consultation. At that time our trained staff will review any parts of the history which may be unclear to us, permitting a “fine tuning” which will set the stage for a thoughtful, informative new patient consultation.

We greatly appreciate your willingness to let our team participate in your efforts to conceive. Should you have questions regarding any aspect of preparing for your first consultation, please do not hesitate to contact us. We are here to help, and we will be happy to assist you.