Get Intermountain He0027-f2 2017-2025

The Intermountain HE0027-F2 form is essential for patients undergoing semen analysis and post-vasectomy specimen collection. This guide provides clear, step-by-step instructions to help users fill out the form accurately and efficiently.

Follow the steps to complete the Intermountain HE0027-F2 form online.

1. Click ‘Get Form’ button to access the online version of the Intermountain HE0027-F2 form.
2. Fill out your personal information in the designated fields. Provide your full name, date of birth, and the name of your clinician. Make sure to double-check for accuracy.
3. Indicate the date and time of collection in the specified format. Ensure that AM/PM is clearly marked.
4. Select the reason for analysis by checking one of the options: Infertility, Post-Vasectomy, or Other. If applicable, provide the name of the associated female for infertility testing.
5. Confirm whether the specimen was collected by masturbation without lubricants by checking 'Yes' or 'No'.
6. Choose the type of specimen container you used. If different from the recommended sterile plastic cup, please describe.
7. Indicate the number of days of abstinence prior to specimen collection.
8. Report any collection or specimen transport problems by selecting either 'No Problems' or 'Problems', and provide a description if necessary.
9. Review all the information for accuracy. Once complete, make sure to save your changes, then proceed to download, print, or share the form as needed.

Complete your Intermountain HE0027-F2 form online today for efficient specimen collection and analysis.