Fertility Patient Health History - Confidential
Welcome to urban sense wellness clinic.

OVERVIEW

Prior to your initial consultation, we ask that you complete this online Patient Health History Form.

As this is a Fertility Consultation, we ask that both you and your partner complete a separate form.

It needs to be completed at least 72 hours prior to your initial consultation. This will allow time for your Practitioner to review your responses in preparation for your appointment. This means that during your consultation, they can spend more time focused on your health issues and key areas of concern.

Urban Sense Wellness clinic uses an evidenced based approach to understanding the underlying causes that disrupt homeostasis and create disease in the body.

This Patient Health History Form is an important document to help your Practitioner to obtain an initial comprehensive overview of your health history.


urban sense wellness clinic
275 St Georges Road
Northcote Victoria 3070
Tel 03 9482 5135
www.urbansensewellnessclinic.com.au 

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