FORMS

NEW CLIENTS

When you schedule a visit, you will receive a link to complete your online intake paperwork through the clinic portal.  Please complete these records prior to your first visit.

 

If you would like to provide previous medical records, please send them to us through:

Email to [email protected] 

Fax to (617) 977-8773

 

*Please note that email is not a HIPPA compliant form of communication.  While we do our best to preserve your privacy with records received by email, there is always the possibility of interception in a non-encrypted email setting.  We recognize that this is the preferred method of sharing information, and we welcome it, but are not responsible for information inadvertently exposed through email.  Thank you*

 

Authorization to Release Medical Records

 

  • Used to acquire medical records from another provider to provide to Hello Fertility OR
  • Used to acquire medical records FROM Hello Fertility for yourself or another provider

 

 

Please note, most medical records are immediately available to you by logging into the patient portal.  (email and password you set up when you booked initial appointment)

Download Medical Records Release

OTHER

 

Notice of Privacy Practices