Would you like to download forms?

Here you find the forms required for your appointment. The downloaded forms can also be filled in on the computer using the free Adobe Acrobat Reader software.
Please send the completed forms, with signatures on the appointment confirmation, prior to your first appointment either via regular mail to:

MVZ Fertility Center Hamburg GmbH
Servicebüro
Speersort 4
20095 Hamburg

or via e-mail to: fch-service@amedes-group.com

For Women and Couples:

• Registration Form
• Medical History Questionnaire (woman)
• Medical History Questionnaire (man)

For Andrology Counselling:

• Registration Form (man)
• Medical History Questionnaire (man)

If you have stored testicular biopsies, cryosperm or unfertilized oocytes with us and would like to terminate the cryopreservation contract at the next possible date (i.e. that the cryopreserved material will be discarded at the end of the contract), please use this form:

• Discard-Cryo_TESE-Cryosperm-Oocytes

If you have stored fertilized eggs (PN's), embryos or donor sperm with us and would like to terminate the cryopreservation contract at the next possible date (i.e. that the cryopreserved material will be discarded after the contract expires), please use this form:

• Discard-Cryo_PN-Embryos-Donorsperm

If you have become pregnant as a result of treatment with us, please do the following:

1. ask your attending doctor to send us the delivery report from the hospital
2. complete the birth report form and send it to the service office (Servicebüro)

• Birth Report

Wenn Sie durch eine Behandlung bei uns schwanger geworden sind, bitten Sie Ihren behandelnden Arzt, uns den Entbindungsbericht aus dem Krankenhaus zuzusenden. Außerdem füllen Sie bitte das Formular "Geburtsbericht" aus und senden es dem Servicebüro zu:

• Geburtsbericht