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New Patient Forms
In order to prepare the patient’s chart before the initial consultation appointment, patients should obtain or complete the information listed below and mail or fax it to our office right away. If patients are not able to forward the paperwork before the day of the appointment, they can bring the information with them, arriving at least 30 minutes before the appointment so we can prepare their chart.
These forms can be mailed to the patient, and are also available below. Completed forms and records should be faxed to FAX# 408-355-1754.
- Request a Fertility / New Patient Consultation – use this Patient Referral Form
- Call for an appointment – 800.597.2234
New Patient Authorization
The fee for the New Patient Consultation appointment is usually covered by insurance. If desired, our insurance specialists can provide specific information about coverage before the appointment.
PLEASE NOTE: If the patient is part of an HMO plan, the patient must obtain prior authorization in order for the New Patient Consultation to be considered for reimbursement by their insurance plan. Without prior authorization, the HMO may reduce a patient’s benefits significantly.
To obtain prior authorization, patients should follow these steps:
- Contact the primary care physician (PCP) or OB/GYN listed on your insurance and request an authorization.
- The physician will review your chart and request a letter of authorization on your behalf.
- The letter is typically mailed to the patient (sometimes a fax is possible).
- Please note it can take up to 72 hours to get approval.
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