Forms to Complete Before Your Appointment

Dr. Mehta and Dr. Guerami are committed to giving couples an honest appraisal of the barriers to successful reproduction and the options that exist for treatment. To assist them in providing the best possible care and treatment, download, print and fill out please fill out the following forms before your appointment.

Patient Registration Form

Universal Consent for Treatment

Medical Release (to FIRM)

Medical Release (from FIRM to another)

Cystic Fibrosis Screening

Patient Bill of Rights

Female Health History form  |   Male Health History form

If possible, please fax the completed forms to 972-377-2667 prior to your appointment. If not, please bring it with you on the day of your first appointment.

Medical History

When a couple makes an appointment at Frisco Institute for Reproductive Medicine, we request that you forward any previous medical records to us prior to your appointment if possible.

These records often help us diagnose the causes of infertility and/or explain why prior therapies may have failed to result in conception or ongoing pregnancy. If such medical information exists, it often makes the first visit very productive.