WCFC Patient Forms
Our most frequently used patient information forms are available online for your convenience. You may print out the pdf registration forms, fill them out, and email to firstname.lastname@example.org or fax to us at (714) 513-1393. Certain pdf forms can be filled out online.
Please note: To view, complete and print FCC fill-in PDF forms you'll need the freely available Adobe Reader software installed on your computer. Click here for detailed instructions on how to fill-in your information on the forms. If you do not have Adobe, click here.
To expedite the registration process for your initial visit to West Coast Fertility Center, we ask that you complete your new patient registration and medical history forms and return them by email or fax. Also, please make a copy and bring it with you on your appointment day.
Medical Records Release Form (in case of previous fertility treatment history)
If you wish Dr. Diaz to review your medical records from prior treatments, please print the enclosed records release form. Send the form or take to your doctor's office to request a copy of your records. Bring the copy of your records on the day of your initial visit to West Coast Fertility.
Please note: It is more productive to go directly to your doctor's office to pick up the medical records personally.