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Ready to take the first step?

There are many factors to consider as you determine the path to parenthood that’s best for you, and everyone’s timeline is different. We partner with you to create a personalized fertility plan, one that addresses your concerns and meets your objectives. Our team is here for you when you’re ready.

We are pleased to offer consultations either via telehealth or in-person. Our scheduling team will be in touch with instructions to help prepare you for your first visit. To ensure we have the opportunity to review your previous testing and treatment records, please complete and send (this form) to all of your relevant care providers as soon as possible. We look forward to meeting you!

Name

Phone

Preferred Method of Communication

Preferred Language

Were You Referred by a Physician?

Yes

How did you hear about us?

If you are ready to schedule your appointment, can you provide some additional details?

Yes

Have you seen any previous doctor’s office for your fertility condition?

Yes

Date of Birth

You can manually enter your birthdate OR use the handy calendar. Use the tab key to move between numbers. From your mobile device, click on the Date that is displayed to scroll through the years/months.

Gender

Do you have insurance?

I am seeking an appointment to discuss

Please keep me informed about Kentucky Fertility Institute services and events.

Yes

Locations:
• Kentucky Fertility Institute (main office)
o hours
• Surgery locations
o Norton Women and Childrens Hospital
o Baptist Health Louisville
o Baptist Health Breckenridge
• Hilton Garden Inn (for remote patients)

Phone
502-996-4480

Fax
502-996-4481

[email protected]

Patient portal
https://patient.kentuckyfertility.com/patientportal
Telehealth appointments
https://doxy.me/drhunterkfi