Provider Referral Form 

If you are a provider (or inquiring on behalf of a provider's office) and would like to contact us, refer a patient, request materials, request a lunch and learn, or if you simply have a question for one of our physicians - please complete the form below.

You may also call our Front Desk at 206-515-0000 and they will be happy to direct your question to the most appropriate staff member. For all Andrology Lab related questions, you may call the lab directly at 206-515-0002 or fax your Andrology Order Forms to 206-515-0003.


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As always, very kind and professional. I'm impressed that I feel personally attended to. Also you guys are always on time.

2017 Anonymous Donor Program Survey
Pacific NW Fertility Patient

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