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{"id":1598,"date":"2025-10-15T09:44:26","date_gmt":"2025-10-15T07:44:26","guid":{"rendered":"https:\/\/www.endlichnachwuchs.de\/formulare\/anamnesebogen-endokrinologie\/"},"modified":"2026-02-27T10:54:11","modified_gmt":"2026-02-27T09:54:11","slug":"endocrinology-medical-history-form","status":"publish","type":"page","link":"https:\/\/www.endlichnachwuchs.de\/en\/forms\/endocrinology-medical-history-form\/","title":{"rendered":"Endocrinology Medical History Form"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column width=&#8221;1\/4&#8243;]\r\n            <img decoding=\"async\" src=\"https:\/\/www.endlichnachwuchs.de\/wp-content\/uploads\/favicon.png\" class=\"img-fluid appear-animation\" data-appear-animation=\"lightSpeedInLeft\" data-appear-animation-delay=\"100\" data-appear-animation-duration=\"1s\">\r\n            [\/vc_column][vc_column width=&#8221;2\/3&#8243; offset=&#8221;vc_col-md-offset-1&#8243; css=&#8221;.vc_custom_1760707785796{margin-bottom: 0px !important;}&#8221;][vc_row_inner equal_height=&#8221;yes&#8221; content_placement=&#8221;middle&#8221;][vc_column_inner width=&#8221;1\/2&#8243;]\r\n              <div class=\"modul-headline text-start mb-4\">\r\n                <div class=\"headlinesmall\"><img decoding=\"async\" src=\"\/wp-content\/themes\/kinderwunsch\/assets\/images\/layout\/hand.png\" alt=\"Kinderwunsch Bodensee\">Download Endocrinology Medical History Form<\/div>\r\n                <h2 class=\"text-start headlinestyle\">Here&#039;s how it works<\/h2>\r\n              <\/div>\r\n            [vc_column_text css=&#8221;&#8221;]Please fill out our medical history form and send it to us by mail or email along with all the necessary documents. Once we have all your documents, we will contact you by phone as soon as possible to schedule an appointment for your initial consultation. Please understand that processing may take up to a week.[\/vc_column_text][vc_empty_space][vc_column_text css=&#8221;&#8221;]<strong>Important information<\/strong><\/p>\n<p>In addition to the medical history form, we also need a referral. Please send us the referral with the form and the subject line \u201cInitial consultation endocrinology\u201d to <a href=\"mailto:mfa@endlichnachwuchs.de\">mfa@endlichnachwuchs.de<\/a>.[\/vc_column_text][vc_empty_space]\r\n            <div class=\"module-button text-center\">\r\n                <a href=\"https:\/\/www.endlichnachwuchs.de\/wp-content\/uploads\/anamnesebogen-endokrinologie-.pdf\" target=\"_blank\"  class=\"btn btn-outline btn-rounded btn-primary btn-inverse mb-2\">Download<\/a>\r\n            <\/div>\r\n            [\/vc_column_inner][vc_column_inner width=&#8221;1\/2&#8243;]\r\n            <div class=\"featured-boxes featured-boxes-flat\">\r\n                <div class=\"featured-box featured-box-primary featured-box-effect-2\">\r\n                    <div class=\"box-content box-content-border-bottom\">\r\n                        <i class=\"icon-featured fa-regular fa-mailbox-open-letter\"><\/i>\r\n                        <div> <h4 style=\"text-align: center;\">Per Post<\/h4>\n<p style=\"text-align: center;\">Kinderwunsch Bodensee<br \/>\nPraxis Dr. Heine<br \/>\nMaggistr. 5<br \/>\n78224 Singen<\/p>\n<\/div>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n            [vc_empty_space]\r\n            <div class=\"featured-boxes featured-boxes-flat\">\r\n                <div class=\"featured-box featured-box-primary featured-box-effect-2\">\r\n                    <div class=\"box-content box-content-border-bottom\">\r\n                        <i class=\"icon-featured fa-regular fa-envelope\"><\/i>\r\n                        <div> <h4 style=\"text-align: center;\">Per E-Mail<\/h4>\n<p style=\"text-align: center;\"><a href=\"mailto:mfa@endlichnachwuchs.de\">mfa@endlichnachwuchs.de<\/a><\/p>\n<\/div>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n            [\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row][vc_column]<div class=\"wpb-content-wrapper\"><p>[vc_row full_width=&#8221;stretch_row_content_no_spaces&#8221;][vc_column css=&#8221;.vc_custom_1760610620505{margin-bottom: 0px !important;}&#8221;]\r\n              <div class=\"modul-headline text-center mb-4\">\r\n                <div class=\"headlinesmall\"><img decoding=\"async\" src=\"\/wp-content\/themes\/kinderwunsch\/assets\/images\/layout\/hand.png\" alt=\"Kinderwunsch Bodensee\">Our work in figures<\/div>\r\n                <h2 class=\"text-center headlinestyle\">Success statistics<\/h2>\r\n              <\/div>\r\n            \r\n                <section class=\"parallax parallax-mouse section section-text-light section-parallax section-center my-0\" data-plugin-parallax data-plugin-options=\"{'mouseParallax': true}\" style=\"background: transparent;\">\r\n\t\t\t\t\t<div class=\"container p-relative z-index-1\">\r\n\t\t\t\t\t\t<div class=\"row justify-content-center counters counters-lg py-5 my-5\">\r\n                                <div class=\"col-lg-3 col-md-4  mb-4 mb-lg-0 text-dark\">\r\n                                    <div class=\"counter\">\r\n                                        <i class=\"fa-thin fa-baby\"><\/i>\r\n                                        <strong data-to=\"43\" class=\"py-3\">43<\/strong>\r\n                                        <label>% Live birth rate from one treatment cycle, including all transfers from frozen cells<\/label>\r\n                                    <\/div>\r\n                                <\/div>\r\n                                <div class=\"col-lg-3 col-md-4  mb-4 mb-lg-0 text-dark\">\r\n                                    <div class=\"counter\">\r\n                                        <i class=\"fa-thin fa-person-pregnant\"><\/i>\r\n                                        <strong data-to=\"35\" class=\"py-3\">35<\/strong>\r\n                                        <label>% Birth rate\/transfer from frozen cells<\/label>\r\n                                    <\/div>\r\n                                <\/div>\r\n                                <div class=\"col-lg-3 col-md-4  mb-4 mb-sm-0 text-dark\">\r\n                                    <div class=\"counter\">\r\n                                        <i class=\"fa-thin fa-person-breastfeeding\"><\/i>\r\n                                        <strong data-to=\"31\" class=\"py-3\">31<\/strong>\r\n                                        <label>% Birth rate\/transfer in the retrieval cycle<\/label>\r\n                                    <\/div>\r\n                                <\/div>\r\n                                \r\n\r\n\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/www.endlichnachwuchs.de\/wp-content\/themes\/kinderwunsch\/assets\/images\/layout\/ei-2-medium.png\" style=\"left: auto; right: -50px;\" class=\"parallax-mouse-object\" data-value=\"-2\" alt=\"\">\r\n\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/www.endlichnachwuchs.de\/wp-content\/themes\/kinderwunsch\/assets\/images\/layout\/kinderhand-medium.png\" style=\"left: 12%; top: 40%; \" class=\"parallax-mouse-object \" data-value=\"-20\" alt=\"\">\r\n\t\t\t\t<\/section>\r\n\r\n\r\n            [\/vc_column][\/vc_row]<\/p>\n<\/div><style type=\"text\/css\" data-type=\"rcb-_wpb_shortcodes_custom_css-1484\">.vc_custom_1760610620505{margin-bottom: 0px !important;}<\/style>[\/vc_column][\/vc_row][vc_row][vc_column]<div class=\"wpb-content-wrapper\"><div class=\"vc_row wpb_row vc_row-fluid vc_custom_1760704835712\"><div class=\"wpb_column vc_column_container vc_col-sm-6\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\r\n                <div class=\"position-absolute z-index-3 floatingimage2\">\r\n                    <div data-plugin-float-element data-plugin-options=\"{'startPos': 'bottom', 'speed': 0.1, 'transition': true, 'transitionDuration': 1000, 'isInsideSVG': true}\">\r\n                        <img decoding=\"async\" src=\"https:\/\/www.endlichnachwuchs.de\/wp-content\/uploads\/favicon.png\" style=\"max-width: 280px;\" class=\"appear-animation border-radius-kiwu img-fluid\" width=\"280\" alt=\"\" data-appear-animation=\"expandIn\" data-appear-animation-delay=\"300\" data-appear-animation-duration=\"600ms\" \/>\r\n                    <\/div>\r\n                <\/div>\r\n                \r\n                <div class=\"position-relative z-index-2 floatingimage1\">\r\n                    <img decoding=\"async\" src=\"https:\/\/www.endlichnachwuchs.de\/wp-content\/uploads\/9.-FAQ-AdobeStock_214983414-min.jpeg\" class=\"appear-animation border-radius-kiwu box-shadow-3 img-fluid\" width=\"\" alt=\"\" data-appear-animation=\"expandIn\" data-appear-animation-duration=\"600ms\" \/>\r\n                    \r\n                    <div class=\"position-absolute z-index-3 floatingimagebtn\">\r\n                        <div data-plugin-float-element data-plugin-options=\"{'startPos': 'top', 'speed': 0.1, 'transition': true, 'transitionDuration': 1000, 'isInsideSVG': true}\">\r\n                            <div class=\"module-button appear-animation\" data-appear-animation=\"expandIn\" data-appear-animation-delay=\"200\" data-appear-animation-duration=\"600ms\">\r\n                                <a href=\"https:\/\/www.endlichnachwuchs.de\/en\/good-to-know\/faq\/\" target=\"\"  class=\"btn btn-outline btn-rounded btn-primary btn-inverse\">More FAQ<\/a>\r\n                            <\/div>\r\n                        <\/div>\r\n                    <\/div>\r\n                <\/div><\/div><\/div><\/div><div class=\"wpb_column vc_column_container vc_col-sm-6\"><div class=\"vc_column-inner vc_custom_1760610659657\"><div class=\"wpb_wrapper\"><section class=\"lazyload \"><div class=\"container appear-animation\" data-appear-animation=\"fadeInUpShorter\" data-appear-animation-delay=\"100\"><div class=\"modul-headline\"><div class=\"headlinesmall\"><img decoding=\"async\" src=\"\/wp-content\/themes\/kinderwunsch\/assets\/images\/layout\/hand.png\" alt=\"Kinderwunsch Bodensee\">Did you know?<\/div><h2 class=\"headlinestyle mb-4\">Q&A<\/h2><\/div><div class=\"accordion accordion-modern-status accordion-modern-status-borders accordion-modern-status-arrow accordion-bggradient faqbordered\" id=\"faqaccordionkinderwunsch\">\r\n                <div class=\"card card-default accordion-lightversion\">\r\n                    <div class=\"card-header\" id=\"collapse200Heading0\">\r\n                        <h4 class=\"card-title m-0\">\r\n                            <a class=\"accordion-toggle text-4 font-weight-semi-bold collapsed\" data-bs-toggle=\"collapse\" data-bs-target=\"#collapse0\" aria-expanded=\"false\" aria-controls=\"collapse0\">\r\n                            What are the age limits for fertility treatment?\r\n                            <\/a>\r\n                        <\/h4>\r\n                    <\/div>\r\n                    <div id=\"collapse0\" class=\"collapse\" aria-labelledby=\"collapse200Heading0\" data-bs-parent=\"#accordionkinderwunsch\" style=\"\">\r\n                        <div class=\"card-body pt-0\">\r\n                            As women reach 40, the chances of a successful pregnancy decrease while risks increase. For these reasons, our clinic treats patients up to the age of 44.\r\n                        <\/div>\r\n                    <\/div>\r\n                <\/div>\r\n                \r\n                <div class=\"card card-default accordion-lightversion\">\r\n                    <div class=\"card-header\" id=\"collapse200Heading1\">\r\n                        <h4 class=\"card-title m-0\">\r\n                            <a class=\"accordion-toggle text-4 font-weight-semi-bold collapsed\" data-bs-toggle=\"collapse\" data-bs-target=\"#collapse1\" aria-expanded=\"false\" aria-controls=\"collapse1\">\r\n                            Do we both need to attend the initial consultation together?\r\n                            <\/a>\r\n                        <\/h4>\r\n                    <\/div>\r\n                    <div id=\"collapse1\" class=\"collapse\" aria-labelledby=\"collapse200Heading1\" data-bs-parent=\"#accordionkinderwunsch\" style=\"\">\r\n                        <div class=\"card-body pt-0\">\r\n                            No, it is not mandatory for both of propulsion to be present at the first appointment. However, we truly value getting to know you as a couple and would be delighted if you could both make it.\r\n                        <\/div>\r\n                    <\/div>\r\n                <\/div>\r\n                \r\n                <div class=\"card card-default accordion-lightversion\">\r\n                    <div class=\"card-header\" id=\"collapse200Heading2\">\r\n                        <h4 class=\"card-title m-0\">\r\n                            <a class=\"accordion-toggle text-4 font-weight-semi-bold collapsed\" data-bs-toggle=\"collapse\" data-bs-target=\"#collapse2\" aria-expanded=\"false\" aria-controls=\"collapse2\">\r\n                            Can the initial consultation be conducted online?\r\n                            <\/a>\r\n                        <\/h4>\r\n                    <\/div>\r\n                    <div id=\"collapse2\" class=\"collapse\" aria-labelledby=\"collapse200Heading2\" data-bs-parent=\"#accordionkinderwunsch\" style=\"\">\r\n                        <div class=\"card-body pt-0\">\r\n                            No, we do not offer online consultations. Given the emotional nature of this journey, we place great value on personal contact. Additionally, we perform initial examinations during the first visit to ensure that fewer follow-up appointments are necessary.\r\n                        <\/div>\r\n                    <\/div>\r\n                <\/div>\r\n                \r\n                <div class=\"card card-default accordion-lightversion\">\r\n                    <div class=\"card-header\" id=\"collapse200Heading3\">\r\n                        <h4 class=\"card-title m-0\">\r\n                            <a class=\"accordion-toggle text-4 font-weight-semi-bold collapsed\" data-bs-toggle=\"collapse\" data-bs-target=\"#collapse3\" aria-expanded=\"false\" aria-controls=\"collapse3\">\r\n                            \"Why is a blood test required at every ultrasound appointment?\r\n                            <\/a>\r\n                        <\/h4>\r\n                    <\/div>\r\n                    <div id=\"collapse3\" class=\"collapse\" aria-labelledby=\"collapse200Heading3\" data-bs-parent=\"#accordionkinderwunsch\" style=\"\">\r\n                        <div class=\"card-body pt-0\">\r\n                            During a treatment cycle, it is crucial to determine the exact timing of ovulation or the trigger point. While an ultrasound provides important visual information, it only offers an estimate. Blood tests, however, allow us to measure precise hormone levels. To monitor how these levels develop, it is necessary to take blood samples several times throughout the cycle\u2014ideally on the same day as your ultrasound.\r\n                        <\/div>\r\n                    <\/div>\r\n                <\/div>\r\n                <\/div><\/div><\/section><\/div><\/div><\/div><\/div>\n<\/div><style type=\"text\/css\" data-type=\"rcb-_wpb_shortcodes_custom_css-1453\">.vc_custom_1760704835712{margin-bottom: 0px !important;}.vc_custom_1760610659657{margin-bottom: 0px !important;}<\/style>[\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"Download Endocrinology Medical History Form Here&#039;s how it works Please fill out our medical history form and send it to us by mail or email along with all the necessary documents. Once we have all your documents, we will contact you by phone as soon as possible to schedule an appointment for your initial consultation. 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