...discovering the future of women’s health care



Medical Care Form

Provide as much information as you can about the medical/surgical care you have received.

It's very important that we are able to contact the hospital or clinic where your gyn surgery was performed so we can request your medical records. If you have your operative or surgical report, you may send a copy.

Medical Release Form

Read through the Authorization to Release Medical Records.

Your medical records and privacy are protected by law, and we need your written permission to request them from doctors and other healthcare providers. We only ask for medical records relating to your gyn surgery.

Family History Form

The information you provide will allow us to anonymously check whether your ancestors are listed in our ancestry database.  We use this database to accurately track genes through extended families, speeding the search and strengthening our research conclusions.

To protect privacy, only public records and individuals born before 1930 are included in this database.

Complete the Forms

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