To refer patient to our doctors, please fill up the form below. Thank you. Attention to: * Dato’ Dr. Colin LeeDr. Haris HamzahDr. Lam Wei KianDr. Leong Wai YewDr. Navdeep Singh PannuDr. Tan Chong SeongDr. Wan Syahirah Yang MohsinDr. Wilkinson TanDr. Melanie Kuan Lih JiunDr. R.M. Udayar Pandian RamachandhiranOthers Patient's Particular Full Name (Wife) * Email address * Phone CLINICAL INFORMATION Relevant History / Findings / Treatments REASON FOR REFERRAL Reason: Fertility Assessment (Inc. Semen Analysis, Abdomen Scan and Transvaginal Scan)Intrauterine Insemination (IUI)Preimplantation Genetic Testing (PGT)In vitro fertilization (IVF)Gynaecology UltrasoundMale InfertilityEgg FreezingOthers REFERRING DOCTOR'S INFO Doctor's Name * Clinic Name * Email * Phone * Δ For more information contact: G01, Ground Floor, Encorp Strand Mall, Jalan PJU 5/22, Kota Damansara, 47810 Petaling Jaya, Selangor, Malaysia Tel: +603-6141 6166 / +6014-941 6388 (to make appointment) Thank you.