Initial Infertility Evaluation. Get Your Answers Within 24 Hours
The following questionnaire is designed to help your physician evaluate your infertility. Please select the appropriate answer. If you have any questions or additional comments, write them in the space provided. The Doctor will inform you  what all steps are to be taken either through mail or phone call.
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Do you suffer from infertility? / Any other uterine disorders ? *
Who is being treated? *
When first diagnosed?
What kind of treatment did you get or you want ? *
Required
Do you think you would like to have an infertility test? *
If you have any questions or additional comments / problems, write here
Your Name *
Contact Number
E-mail ID *
Country *
City *
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