Patient Referral Form

1. Name
2. MSP #
3. Office Phone

1. Name
2. Date of Birth
3. PHN #
4. Street
5. City
6. Province
7. Country
8. Postal Code
9. Phone
10. Email

1. Name
2. Date of Birth
3. PHN #

Infertility and Assisted Reproduction

1. Infertility Investigation and Management
2. Ovulation Induction
3. In Vitro Fertilization (IVF)
4. Intrauterine Insemination (IUI)
5. Donor Sperm Insemination
6. Egg Cryopreservation
7. Sperm Cryopreservation
8. Preimplantation Genetic Diagnosis (PGD)
9. Reversal of Tubal Ligation
10. Endometriosis

Andrology

1. Sperm Functional Assessment
2. Pre-ICSI Assessment
3. Sperm Cryobanking

Reproductive Endocrinology

1. Polycystic Ovary Syndrome
2. Amenorrhea and Irregular Periods
3. Hyperprolactinemia
4. Menopause