Infertility Acupuncture Fertility Pregnancy Treatment The Fertile Soul

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Recorded Conference Calls with Dr. Randine Lewis

Listen to recorded call Topics with Dr. Lewis with QnA segments at the end of each recording.

 Click here to access the call archive


Patient Consult Forms

Please fill out the proper forms prior to your appointment to help us get to know you and your medical history. These will only take a few moments of your time. Please return copies via:


Email:       (Retreat Information)

    (Phone Consult Information)

Fax: (203) 774-1119

TFS Patient Form (Female)


TFS Patient Form



Physical Questionnaire (Female)


Physical Questionnaire (Male)


TCM LifeStyle Questionnaire


Nutrition Intake Form


Wellness Intake Form



*If using a Mac computer - "Open PDF in Preview" before filling out the form OR Save the PDF to your computer prior to filling out (information will not save properly if filled out directly from web)


Acrobat Reader The forms on this page require you to have Adobe Acrobat Reader installed on your system. Click the icon to download...

The Fertile Soul LLC 2004-2011. All Rights Reserved.
The Fertile Soul, 26 Glen Cove Rd, Arden, North Carolina 28704
Achieve pregnancy through Acupuncture and traditional Chinese herbal medicine as treatment for infertility.
We use Acupuncture and alternative medicine as infertility treatment to produce pregnancy.
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