For new individuals seeking their first educational consultation: 

Please click on the links below to open the files in PDF format, which you can then print and fill out. Click on the "back" button in your browser to get back to this site.  Please send us all 3 of the following documents:  All individual gender identities and sexual preferences are welcome.

  1. Initial Pelvic Pain Questionnaire - Genital anatomy female
    Initial Pelvic Pain Questionnaire - Genital anatomy male
  2. Past & Family Medical History Form
  3. Demographic Information

 

Office address:

The Echenberg Institute

933 Center St.

Bethlehem, PA, 18018

E-mail:  office@drechenberg.com or info@TheEchenbergInstitute.com

Office phone:  610-868-0104

Office fax:  610-868-0204