New Appointment Information

Please call 801-878-8888 or email info@FertilityDr.com to schedule a new patient appointment then follow the instructions below.

We look forward to welcoming you to our practice and want to acquaint you with some of our office procedures. Prepare for your initial appointment by filling out the medical questionnaire and registration information (see hyperlinks below) to the best of your ability. Please FAX (801-878-8890) or mail the completed forms to our office in order for it to arrive at least 3 days prior to your scheduled initial consultation. A digital version of the registration and history form is available for electronic completion (can be printed, signed and returned or the completed form can be sent back (preferred) electronically to info@FertilityDr.com and signed during the appointment). Secure encrypted email options are available if desired.

1. Patient Registration Form:
   Registration Form (pdf format)
   Patient Registration Digital Format; Patient Registration Digital v2
2. Medical Information Questionnaire that has questions for both the husband and the wife.
   Patient Medical Information Questionnaire v13 (.pdf format) or Patient Medical Information Questionnaire (digital) v6

Basic Information about the New Appointment

1. Our office in Sandy is open from 8:00 am to 5:00 pm, Monday through Friday for appointments.  New consultations are also available on Saturdays.  Weekend care is provided for treatment procedures.
2. No lab work or other procedure is included in the charge for the initial consultation.
3. We are located at 10150 S. Petunia Way (10150 S 1405 E). We are directly South of the Sandy City Library. There is easy parking and access.
4. If you have consulted with other physicians or practices regarding your infertility, please request that copies of your records from each physician be sent in advance.
1. For the wife, specifically request reports for any previously completed hormonal testing (such as Prolactin, TSH, day 3 FSH, day 3 estradiol, day 10 FSH, testosterone, DHEAS, fasting glucose, 2 hour glucose or fasting insulin levels), Clomiphene Citrate Challenge test (CCCT), a saline sonogram (hysterosonogram) with pictures, hysterosalpingogram (HSG) with the actual x-ray, prior obstetrical records, immunization records specifically for rubella (German Measles) and varicella (Chickenpox), laparoscopic or hysteroscopic surgery, and any pelvic surgery. X-ray films (many are now digital on a CD) should be obtained from the radiology department where they were performed. Operative reports may need to be obtained from the hospital but are usually available from the physician’s office. Records regarding any treatment such as clomiphene citrate, letrozole, gonadotropin (FSH) injections, intrauterine insemination (IUI) or in vitro fertilization (IVF) should also be obtained.
2. For the husband, please include copies of semen analysis reports, insemination preparation reports, urologic examinations, scrotal ultrasounds, any hormone testing (such as testosterone, prolactin, TSH and FSH) and any pertinent reproductive surgery (hernia repair, vasectomy, vasectomy reversal, etc).
5. Completing the registration form, questionnaire and obtaining all pertinent medical records in advance will allow our physicians to have access to all your records prior to your arrival. This will enable us to provide the best advice possible for your particular medical situation during your initial consultation. If these records are not received at least 3 days prior to your appointment, we recommend that you reschedule. If you prefer to proceed without sending the records in advance, you must provide a credit card for billing which will be charged for the appointment.
6. If you are unable to make your scheduled initial appointment we require a minimum of 72 hours notice or a $75 charge will be assessed.
7. Payment is expected at the time services are rendered.
8. Please bring your insurance card(s) to your appointment if you would like us to submit your charges to an insurance company.

We look forward to helping you achieve your fertility goals.