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Andrology Patient Forms

If you have a scheduled appointment, are being referred to us for IUI sperm preparation, or have a scheduled Testicular Biopsy, the following forms will need to be completed by you. If your partner plans to bring in your sample, you should fill out and print these forms to be brought in with your sample. Be sure to request filing of a courtesy claim if you wish to file insurance. Thank you.

  Patient Information Form

  Supplemental Patient Information Form

  Patient Instructions for Semen Collection

  Notice of Privacy Practices