For All New Patients
- New Patient Visit Checklist
- Notice of Privacy Practices
- Carrier Screening Information
- Demographic Form – Please complete, then save as your last name and email to firstname.lastname@example.org
- Patient Health History and Consent Forms – Choose the most appropriate Health History & Consent packet, complete, print, and sign consent. If in a relationship, patient and partner will need to complete their own Health History & Consent Form packet. Bring completed packet(s) to your appointment.
IVF Consents – effective Jan. 2019
Effective Jan 1, 2019, the new IVF consents must be completed, notarized* and returned to the IVF staff prior to an IVF cycle start.
*If it is impossible to have the consents notarized they must be signed by both parties in the presence of a Main Line Fertility employee after presenting photo ID prior to an IVF cycle start.