Reproductive Medicine Center in Fort Collins, CO

New Patient Forms

Prior to your appointment, there are several forms that will need to be completed electronically in our patient portal. Please click the purple button below to begin this process.

Health History Packet

To make the most of your visit, our providers prefer to review your medical history prior to your first appointment. Sending your records in advance will move the process along and may enable you to bypass duplicating tests. You have options to fill out electronically and print OR print and fill out by hand. Please mail, fax, or attach to portal your new patient packet to return to our office as soon as possible.

Please follow these steps in order to ensure your form is completed and returned as requested:

Download the Health History Form (this may require you to download a free version of Adobe Reader)
On your computer, open the downloaded file.
Fill out your packet (either electronically and save OR print and complete by hand).
Return to us via one of the following:

Upload through PrognoCIS Portal (once logged in, go to Message Center > Compose and attach the PDF)
Fax it to us at 970-493-6366
Mail it to us at 1080 E Elizabeth Street, Fort Collins, CO 80525

New Patient Records Release

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Existing Patient Records Release