To book your first visit to the Vancouver fertility clinic:

If your physician hasn’t already sent a referral, please download the appropriate form below and have them fax it to us.

If you do not have a referring physician, or its difficult for you to obtain a referral from your doctor, we recommend obtaining a referral via EQ Virtual.

To self-refer:  Please note there is a $100 private non-refundable fee for self-referrals, due at the time of booking.

Fill in the self referral form below or contact our Referral Coordinator at:

604-422-7276 or toll free at 1-866-481-7276

Email:  referrals@pacificfertility.ca

Referral Forms

Self Referral Form