Patient Self-Referrals

Welcome to Tripod Fertility

We offer a self-referral service for all persons needing fertility help. This allows you to take your fertility needs into your own hands, and allows us to give you to experience patient care as soon as possible.  We are available for assessment of infertility, fertility preservation, as well as prenatal care, and gynecology consultation care.

Complete the Patient Self-Referral form below and click Send.  Alternatively, you can download a PDF version and send it to

**In order to complete a semen analysis at Tripod Fertility you will need to book an appointment to speak to one of our fertility specialists.  

[contact-form-7 id="146" title="Physician Referral"]
[contact-form-7 id="147" title="Patient Self-Referral"]
[contact-form-7 id="147" title="Patient Self-Referral"]

Click or drag a file to this area to upload.