Patient Resources

Patient Forms & Downloads

Download official VCRM paperwork, intake questionnaires, office policies, and consents prior to your initial visit.

Need Help With Forms?

Our patient care team is available to assist you with registration and documentation.

Contact Office (703) 437-7722
Visit Preparation

What to Submit at Your First Visit

To make your initial consultation as smooth and effective as possible, please plan to arrive at least 15 minutes prior to your scheduled appointment time with the following completed materials:

  • Completed Demographic & Registration Form
  • Copy of Insurance Card & Driver's License
  • Completed Patient Intake Questionnaire
  • All Previous Medical & Fertility Records
  • HIPAA & Confidentiality Forms
Patient Intake

Intake & Registration Documents

Please complete and bring these required registration forms to your first appointment:

New Patient Questionnaire Packet Comprehensive medical history & fertility evaluation form (PDF)
Download PDF
Patient Registration Form Official demographic & personal contact registration form (DOC)
Download DOC
Patient Confidentiality & HIPAA Form HIPAA privacy agreement & records authorization form (PDF)
Download PDF
Clinic Guidelines

Office Policies, Financial & Consents

Review and sign our clinical agreements and practice policies prior to treatment:

Office Policy Agreement Scheduling, 24-hour cancellation notice, and clinic policies (DOC)
Download DOC
Payment & Financial Policy Financial responsibility, billing terms, and insurance guidelines (PDF)
Download PDF
Consent for Treatment Form Informed consent agreement for reproductive clinical care (PDF)
Download PDF
ASRM Smoking & Fertility Fact Sheet American Society for Reproductive Medicine smoking impact guide (PDF)
Download PDF
Additional Resources

Related Patient Resources

Patient Resources & Policies

Learn about clinic protocols, insurance coverage, and support services.

View Resources

The Infertility Diet™

Dr. Sharara's evidence-based nutrition protocol for egg & sperm quality.

Explore Diet Guide

Reston Clinic Location

Address, directions, hours, and direct contact details for VCRM.

Get Directions
Next Step

Ready to talk with VCRM?

Start with a personal consultation request or call our Reston clinic directly at (703) 437-7722.

Schedule a Consultation View Patient Guide