New Patient Forms
Please fill & sign all forms and bring these with you on your first visit.
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SIGN copies of record release and get them to those centers, that have records you wish us to review. You may have to have your husband/partner sign their own release.
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Please make an enlarge copy of your insurance card (front & back) and fax it to our office, 602-493-6641, in advance of your appointment. You can also email to frontdesk@ivfphoenix.com. This will allow us time to check on your benefits.
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Please note that IVF Phoenix™ is a fragrance-free clinic. Please do not wear perfumes or colognes to IVF Phoenix™. Thank you!
Forms Below:
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General Medical Request form: To request records from your OB or Primary Care
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ART Medical Request form: To request records from a prior Fertility Practice