New Patient Contact Form

Thank you for your interest in NCFMC! Please fill out the form below and we will contact you.

Thank you for contacting NCFMC! We are here to help!

At Northern California Fertility Medical Center, our infertility specialists provide patients from Roseville, Sacramento, Davis and across the West Coast with advanced and effective treatment for a wide range of fertility problems.

At your initial appointment, you will meet with one of our physicians and discuss your medical history as well as ask any questions, while gaining understanding, of  your treatment options choices. It is our number one goal that you are confident with your treatment plan to give you the outcome you desire.

Downloadable Patient Intake Form


PLEASE DO NOT ENTER ANY HEALTHCARE INFORMATION INTO OUR FORM. IT IS NOT HIPAA COMPLIANT, AND THEREFORE SHOULD ONLY BE USED FOR STANDARD COMMUNICATION.

If you are an EXISTING PATIENT who would like to contact us, please use the Patient Portal.

New Patient Appointment Request. Please fill out form below.

We are expecting a high volume of new patient requests. Please allow us several business days before responding to your request.

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