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Treating Infertility
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Constant Contact
safe secure subscriptions.
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: jesse@thefertilesoul.com (Retreat Information)
theresa@thefertilesoul.com (Phone Consult Information)
Fax: (203) 774-1119
TFS Patient Form (Female)
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TFS Patient Form (Male)
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Physical Questionnaire (Female)
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Physical Questionnaire (Male)
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TCM LifeStyle Questionnaire
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Nutrition Intake Form
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Wellness Intake Form
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*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)
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The forms on this page require you to have Adobe Acrobat Reader installed on your system. Click the icon to download... |