| At Connecticut Fertility Associates, we want you to be fully informed about the tests and fertility
treatments we offer. Feel free to open these forms, print and fill out prior to visiting our offices. New Patient Forms | |
| Female Patient History | This summarizes all important aspects of your fertility and medical history, as well as any previous testing or treatment you may have received. |
| Record Release | This form authorizes us to obtain your medical history from visits with other doctors, and laboratories. |
Forms used for Basic Treatments | |
| Superovulation Therapy | This consent form reviews the benefits and risks of superovulation therapy using injectable fertility medications. |
| Artificial Insemination | This consent form reviews the benefits and risks of artificial insemination using intrauterine insemination (IUI) therapy. |
| Therapeutic Donor Insemination | This consent form reviews the benefits and risks of insemination therapy with donor sperm. |
Forms used for Assisted Reproductive Technology (ART) Treatments During our ART procedures, such as IVF, ICSI, PGD etc. you will come in contact with forms similar to these listed below. | |
| IVF, ICSI, AH & Embryo Feezing | This consent form will reviews the benefits and risks of IVF, ICSI, Assisted Hatching (AH) and Embryo Freezing. |
| Pre-implantation Genetic Diagnosis | This consent form reviews the benefits and risks of (PGD). |
| Cryo Preservation Thawing | This consent form allows us to thaw and implant previously frozen embryos into the uterus . |
| Egg Donor Use | This consent form allows us to perform egg donor therapy with use of IVF and Embryo Transfer technologies. |
Forms used for Patient Feedback | |
| Confidential Patient Survey | Please use this form to rate our performance, we strive to be better all the time. |
