Patient Forms

Before your first visit

To save time, complete these forms and forward them to our office before your first appointment. Our fax number and mailing address are provided below.

Please bring a copy of these documents to your appointment.

Follow My Health patient portal

The online patient portal is a secure way to manage your health care information and communicate with your physicians at Washington University School of Medicine.
Sign up or log in »

Medical records release

Use this release form to obtain a copy of your records from your medical provider(s). Please complete the form in its entirety, sign and date, and send it to us via fax or mail (see contact information below).
Patient Records Release Form (pdf)

Sending us your forms

Fax: 314-286-2455
Mail: Please send all mail to our Central West End Location

Fertility and Reproductive Medicine Center
4444 Forest Park Ave., Suite 3100
St. Louis, MO 63110