Patient Forms

If you are a new patient, please fill the applicable forms from below and submit them to our office at least one week prior to your appointment. Forms should be emailed to: or faxed to (412) 571-9355. You may also opt to mail the forms to: Trillium Natural Medicine, 3043 West Liberty Ave., Pittsburgh, PA 15216 and please let us know if you send them this way. If you are a new patient coming in for a fertility consult, please fill out both the Adult Patient Packet and the Fertility Healthy History. If you would prefer to have us mail you a paper copy, please let us know. Thank you!