The Fertility Center of Las Vegas
  • Please complete this form to request medical records to be released to The Fertility Center of Las Vegas/Ovation Fertility/Granite Surgery.

  • Insert your Doctor's name here.
  • Records should be from within the past 12 months from an OBGYN, Primary Care, Perinatologist, or other Fertility Specialist. Relevant records include lab work, HSG, semen analysis, previous IUI/IVF treatment including cycle flow sheets and embryo information.
  • Please use a mouse on your desktop/laptop or a stylus / your finger to sign on a tablet.