Thank you for your interest in a free Records Review at The Center for Restorative Reproductive Surgery.  The Records Review is a thirty-minute phone call where you and the doctor will discuss your medical history and health goals.  For potential patients living outside of the US, we use Microsoft Teams.

To schedule a Records Review, please complete the form below. Afterwards, you will be redirected to our self-scheduling calendar.  If you're unable to schedule the Records Review at this time, the same link to the calendar will appear in the confirmation email.  Please ensure the spelling and information for the Records Review is the same as the Intake Form.

This form has three medical records request forms.  If you would like us to request medical records from additional providers, you can follow the link provided in the confirmation email after completeing this form.

About one business day after the Records Review, you will receive an email regarding surgery planning.  The email would include the surgery fee.  It would also include the information needed to determine the hospital fees at Northside Hospital.