IVF Consultation Form
What an IVF consultation form asks, with sample questions on past IVF cycles, earlier treatment, tests, and health.
An IVF consultation form records past IVF cycles, earlier fertility treatment and tests, partner details, and health history before a consultation about IVF. The questions on this page come from the IVF and treatment history sections of the ASRM Infertility History Form and Northwestern Medicine's fertility health history form.
IVF consultation form, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on an IVF consultation form in the patient's own language, strictly following the practice's instructions.
- Intake before the visit. Patients answer online before they arrive, or at a kiosk when they check in.
- Answers ready for the clinician. Clinicians see what the patient said before the visit starts.
- Less workload at the front desk. Staff spend less time handing out forms and entering answers by hand.
- Key details at a glance. The care team sees what matters up front and decides who needs attention first.
The form becomes a natural conversation: patients answer by talking, in their own words. AI Doctor is an information and patient-assistance interface. It collects answers for the care team to review. It doesn't diagnose, triage, or give treatment advice.
Sample IVF consultation form questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- What is the reason for your visit?Visit reason
- How many years have you been trying to conceive?Visit reason
- How many eggs were retrieved in each cycle?IVF cycles
- Have any IVF attempts been canceled?IVF cycles
- Have you had insemination with partner or donor sperm?Earlier treatment
- Have you taken clomiphene, letrozole, or fertility shots?Earlier treatment
- Have you had an HSG x-ray of your tubes?Earlier tests
- Have you had a day 3 FSH blood test?Earlier tests
- Do you have a partner?Partner
- Has a semen analysis ever been done?Partner
- Are you allergic to any foods?Health history
- Do you take over-the-counter medicines?Health history
These are examples to read, not a form to fill in.
IVF consultation form: FAQ
What does an IVF consultation form ask?
The sample questions on this page are based on the ASRM Infertility History Form and Northwestern Medicine's fertility health history form. This page groups them into six areas: visit reason, IVF cycles, earlier treatment, earlier tests, partner, and health history.
Who fills in the form, and when?
The patient, before the consultation. Northwestern Medicine's form says patients who need help can contact the office, and they may be asked to arrive half an hour early.
Does it ask for details of each past IVF cycle?
For each completed cycle, the ASRM form records the eggs, embryos transferred and frozen, and whether a pregnancy followed. It also asks about frozen transfers and canceled attempts.
Does an IVF consultation form ask about a partner?
Northwestern Medicine's form has a partner section, marked 'if applicable', with age, date of birth, sex assigned at birth, gender identity, and preferred name. It also asks whether a partner has had a semen analysis.
Does AI Doctor explain test results?
No. AI Doctor only asks the questions and records the answers; earlier test results stay with the practice's team.
Is there an IVF consultation form template?
The sample questions on this page show a typical set, taken from the IVF and treatment sections of two fertility history forms.
Does AI Doctor give medical advice?
No. It collects information for the care team. It doesn't diagnose, triage, or recommend treatment.
Can patient answers stay on our own servers?
Yes. RAVATAR offers on-prem deployment: the platform can run inside your own perimeter, so patient answers stay there. RAVATAR complies with GDPR and the EU AI Act.
Set up your AI Doctor in Genesis AI Avatar Studio
Genesis AI Avatar Studio is where you set up, test, and publish AI avatars for your website, mobile app, or Holobox. No coding or technical skills needed.
- 01Choose the AI Doctor avatar.
- 02Add your practice's FAQs and visit information.
- 03Talk to it, then publish it.
