New Patient Request Form Received

Thank you for submitting your request to become a new patient at NewLIFE. 

It is our goal to make your initial visit with us as positive and productive as possible. With this in mind, we require that all New Patient’s complete their New Patient Medical History Forms and Authorizations (patient and partner if applicable) BEFORE your new patient consultation with one of our providers will be scheduled. The only exception to this is if you completed a new patient request form for a Semen Analysis only, the new patient medical history form is not required. 

Please complete the next step in the application process: Medical History Form.  If you need to continue later, check your email for the link to complete your application.

Once you submit all paperwork, a NewLIFE representative will contact you in the next 5-7 business days.