Dr Colins Reproductive Health
Dr Colin's Ferti-boost
Dr Colin's Reproductive Health
Dr Colin's Reproductive Health
Dr Colin's Reproductive Health
Dr Colin's Reproductive Health
 

Register your Ferti-boost™ success here!

Thank you for taking the time to share your special success story with us – we are so excited to be hearing from you! Fill out the questions below, and we will enter your name into our monthly lucky draw!

 
       
 

A. Tell us about yourselves:

   
  Your names:
Mom:
Dad:
 
  Your ages:
Mom:
Dad:
 
  Baby's name:  
  Baby's birth date:  
  How can we contact you?
By SMS :
By Email :
 
       
 

B. Tell us about your fertility story:

   
  When did you start trying to have a baby?  
  Did you visit a doctor / health care practitioner?
Did you have any medical investigations? 		 
   
  If you did, when did you decide to seek help for infertility?  
  Did you discover a specific reason for your inability to fall pregnant?
Do you have a diagnosis, specific infertility-related condition, or any chronic medical complaints? 		 
   
  Did you undergo any form of treatment?
For how long? How did it make you feel?		  
   
       
 

C. Ferti-boost™ and you:

   
  How did you learn about Ferti-boost™?  
   
  When did you first start using the product?  
  For how long did you use the product?  
  How did you feel while using the product?  
   
  Did you use our website, our forum, or contact any of the doctors at the LIFE CENTRE? If so, was the support helpful?  
   
       
 

D. Anything else?

Anything else you would like to share with us about yourselves, your lives or your journey to success? Do you have any advice for the couples out there who are battling to have a baby?

Please write your comments in the box below – this is your chance to tell us about your experiences or offer suggestions and comments.

 
   
     
 
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Before submitting your success story please read the following:

  • I/We consent to the use of our story and the attached picture on this website and associated newsletters.
  • Dr Colin's Ferti-boost™ promises to keep your contact details private and will only use your first names on the website and associated newsletters.
  • I/We agree that all information is accurate.