Patient Registration Materials

Please complete these forms before your first visit. Plan 60–90 minutes total, completed across several sittings if needed. Submitting in advance lets your clinician review your history before you arrive.

Before you start: Have your medication list, insurance card, and PCP contact info ready. Schedule lab work at least 3 weeks before your visit.

Required for every patient

Patient Registration and History Packet

13 pages · 30–45 min

Registration, consents, medical and sexual history, ACE screening. Same packet for all patients.

Download Packet

Validated Clinical Questionnaires

15–20 min

PHQ-9, Perceived Stress Scale, Sexual Distress Scale, plus FSFI (female) or IIEF (male). Choose the version matching the anatomy being evaluated.

Female Version Male Version

Laboratory Requisition

Complete 3 weeks ahead

Bring to any lab for hormone panel. Panels differ by sex due to different reference ranges.

Female Lab Order Male Lab Order

Complete only if applicable to you

Pain Catastrophizing Scale

1 page

If you have genital, pelvic, or sexual pain, including PGAD.

Download PCS

Peyronie's Disease Questionnaire

5 pages

For men with diagnosed or suspected Peyronie's disease.

Download PDQ

How To Submit Your Completed Forms

Once you've completed the forms, choose one of the options below. For your privacy, please do not email completed forms — email is not a secure transmission method for protected health information.

Fax: 619.265.7696
Mail: San Diego Sexual Medicine, 5555 Reservoir Drive, Suite 300, San Diego, CA 92120
Bring to your appointment: please arrive 30 minutes early if you choose this option

Take charge of your sexual health.

Many of our patients arrive at our practice having been told for years that their condition is not real, not treatable, or not worth discussing. It is real. It is treatable. And at San Diego Sexual Medicine, this is what we specialize in. This is what we are known for. This is what we do

Schedule your free courtesy call