201 W NORTH RIVER DR #100
SPOKANE, WA 99291
OFFICE (509) 462-7070
FAX (509) 462 – 7071

Patient Forms & Downloads

How We Work

Patient Forms & Downloads

For Female Patients

To provide you with the highest level of care, the Center for Reproductive Health requires all new patients to complete important forms prior to their first visit. Submitting these forms ahead of time allows our team to review your medical history and prepare for your consultation, ensuring the most efficient and personalized care.

1 - Female Questionnaire – Download PDF

This form collects comprehensive information about your reproductive history, health background, and any previous fertility treatments.

2 - Release of Health Information – Download PDF

This form authorizes the release of your medical records, which may be necessary to coordinate your care with other healthcare providers.

3 - Intake Form – Download PDF

This document helps us gather essential contact information, insurance details, and additional background for your patient file.

For Male Patients

If you’re a male patient, please complete and submit the following form:

1 - Male Questionnaire – Download PDF

This form gathers key information about your medical and reproductive history, which is crucial for developing a personalized treatment plan.

How to Submit Your Forms

Once you’ve filled out the appropriate forms, please return them to our office as soon as possible before your appointment. 

Need Assistance?

If you have any questions about the forms or need help completing them, our team is here to assist you. Please don’t hesitate to call us at 509-213-0990. We look forward to helping you on your fertility journey.