Print, Complete & Send to Us
Please print appropriate Physical Exam Form(s) below. Exam can be performed at Fertility Treatment Center (no charge) or a provider of your choice. Two forms are provided, one for the patient (only if used own egg) and one for the partner (only if partner sperm).
Should you choose to have your physical examinations and blood testing carried out at Fertility Treatment Center, please call our office and speak with Michella or Marissa at (602) 975-0114 or complete the contact form below.
Should you have any questions, please call our office and speak with Michella or Marrisa at (602) 975-0114 or complete the contact form below.
Click this link to upload your completed PDF form UPLOAD.