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(585) 473-8770
The Center for Menstrual Disorders
    • Menstrual Disorders, Fibroids & Polyps
    • Endometrial Ablation Failure
    • Women’s Health
    • What to Expect for Out of Town Patients
    • Articles & Publications
    • About Us
    • Home
    • Menstrual Disorders, Fibroids & Polyps
      • Causes of Heavy Periods / Menstrual Flow
      • Testing for Heavy Periods / Bleeding
        • Transvaginal Ultrasound
        • Endometrial Biopsy
        • Sonohysterogram (SHG)
        • Diagnostic Hysteroscopy
        • Blood Tests
      • Treatment Options for Menstrual Disorders
        • Observation
        • Medications
        • Intrauterine Devices (IUDs)
        • Minimally Invasive Gynecologic Surgery: Endometrial Ablation, Endomyometrial Resection, Hysterectomy
        • Endomyometrial Resection (EMR)
        • Uterine Polyps (Endometrial Polyps) & Hysteroscopic Polypectomy
        • Hysteroscopic Myomectomy with Ultrasound Guidance
      • Fibroids
        • Fibroids & Your Health
        • No Two Fibroids Are Alike
        • Diagnosing Uterine Fibroids
        • Treatment of Fibroids
        • Doing “Nothing” About Fibroids
        • References
      • Endometrial Polyps
      • Post-Menopausal Bleeding
        • What are the causes of PMB?
        • Testing for the causes of PMB
        • “See and Treat Hysteroscopy”
      • Recommendations for Women undergoing Endomyometrial Resection and all forms of endometrial ablation
    • What is Late-Onset Endometrial Ablation Failure (LOEAF)?
      • Treatment of Endometrial Ablation Failure
      • What’s Next
      • Ultrasound-Guided Reoperative Hysteroscopic Surgery
      • Management Options for Women at Risk for Endometrial Ablation or Endomyometrial Resection (EMR) Failure
    • Women’s Health
      • Birth Control
      • Breast Cancer
      • Cardiovascular Disease & Stroke
      • Cholesterol & Triglycerides
      • Colonoscopy
      • Hypertension
      • Menopause
      • Obesity
      • Osteopenia & Osteoporosis
      • Ovarian Cysts
      • Pap Smears
      • NEPT (Non-Elective Termination of Pregnancy) and Elective Abortion
        • Surgical Abortion
          • Pain Relief & Sedation
      • Sexually Transmitted Diseases (STD)
      • Smoking Cessation
    • What to Expect for Out of Town Patients
      • Day #1—Consultation and Laminaria Placement
      • Day #2: Your Surgery
      • Day #3: Your First Post-Op Day
    • Articles & Publications
    • About Us
      • Office-Based Surgery Benefits
      • Dr. Morris Wortman
      • Amy Daggett, RN, ANP
      • Testimonials & Reviews
      • Patient Forms
        • FACE Sheet
        • Established Patient Intake Form
        • New Patient Intake Form
        • Patient Information Sheet
      • Patient Survey
    • Blog
    • Contact & Forms
About Us
  • Cost/Benefit of Office-Based Surgery
  • Dr. Morris Wortman
  • Amy Daggett, RN, ANP
  • Testimonials & Reviews
  • Patient Survey
  • Patient Forms
See Our Reviews

About Us

Patient Forms

We have provided these forms for your convenience

Patient Information Sheet

Obtaining Medial Records

New Patient Intake Form

Established Patient Intake Form

FACE Sheet

The Center for Menstrual Disorders

2020 South Clinton Avenue, Rochester, New York 14618

  • Home
  • Menstrual Disorders, Fibroids & Polyps
  • Endometrial Ablation Failure
  • Women’s Health
  • What to Expect for Out of Town Patients
  • Articles & Publications
  • About Us
  • Blog
  • Contact & Forms
  • Site Map
Member of the Monroe County Medical Society
(585) 473-8770
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