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Cycle start notification
We require the following information to coordinate the examinations included in your treatment plan
Contact details
Last name
Email address
First name
Telephone number
Birthdate
Please enter your date of birth
Cycle information
When was your 1st cycle day?
First day of regular (red) period bleeding. Pure ‘spotting’ does not count as the start of the cycle.
Average cycle length (from day 1 to day 1 of next cycle)
For which planned measures are you reporting the start of your period?
Diagnostic cycle examinations
(fallopian tubes: HyCoSy; uterus: hysteroscopy; mucous membrane: biopsy)
Cycle monitoring or insemination
IVF/ICSI
Natural Cycle / Mini IVF
(without anaesthesia)
Thawing cycle
(frozen embryo transfer)
Other
Other
Appointment
Praxis Standort
-- Bitte wählen --
Zürich
Zollikon
Absences
Days on which I cannot attend appointments at the practice under any circumstances
Monday
Tuesday
Wednesday
Thursday
Friday
Comments, questions, requests
