Fertility Intake Form

Please bring any blood analysis, semen analysis, specialist reports/ultrasound report you have with you to your first appointment. 

Your first appointment will be 75 mins and I will gather additional information that is crucial for me to understand you and your health concerns and goals. We will begin to formulate an action plan to give you the results you want. It is essential and beneficial that we begin this process by your investment in time taken to complete the attached questionnaires.

Naturopathic Treatment is individualised for your needs and will be based on the findings of this appointment. I am a University Qualified Naturopath specialising in Reproductive Medicine and Womens Health. Nourish and Breathe Clinic offers health plans and programs within a framework of nutritional and herbal healing implemented with dietary and lifestyle guidelines for guaranteed results. Our goal together is for you to achieve and maintain your optimal health and for this to become the way you live your life.