Patient Forms and
Consent Documents

Please review all patient and consent forms with your partner prior to your appointment. (Please note, patient forms and consent documents are only accessible via computer i.e. desktop, laptop, etc.)

New Patient Forms

• New Patient Requirements
• Instructions for Semen Analysis
• Authorization Form for Release of Confidential Health Information
• Privacy policy
• Maps

Medication Preparation Forms

• Single Injection Lupron Protocol
• Single Injection Ganirelex Protocol

Embryology Consents

• Consent to relinquish parental rights of embryos
• Consent to transfer embryos
• Consent to transfer sperm
• Instructions for Semen Analysis
• Semen Disposition Consent

A.R.T. Consents

• CF Carrier Screening Waiver
• Cryopreservation Consent
• Disposition of Eggs Declaration
• Disposition of Embryos Declaration
• Egg Cryopreservation Information
• Fertility Enhancing Medication Consent
• In-Vitro Fertilization
• Multiple Pregnancy Consent
• Payment Policy for Freezing

Donor Embryo Recipient Consents

• Acknowledgement of Donor Embryo Thaw
• Donor Embryo Recipient Consent
• Embryo Thaw and Transfer Consent
• Gestational Surrogacy Consent

Donor Oocyte Recipient Consents

• Oocyte Freezing Consent
• Donor Oocyte Consent--Recipient
• Donor Ooytes in A.R.T.
• Oocyte Recipient Consent
• Prospective Parents Financial Agreement

Embryo Thaw and Transfer Consents

• Acknowledgement of Embryo Thaw
• Embryo Thaw and Transfer Consent

Shared IVF Success Program Consents

• Shared IVF Success Agreement
• Shared IVF Success Donor Oocyte Program Agreement

Other Online Consents

• Cryopreservation Consent
• Egg Donor Consent
• Fertility Enhancing Medication Consent
• Multiple Pregnancy Consent
• Therapeutic Donor Sperm for I.V.F. Consent
• PGD Consent
• Therapeutic Donor Insem Consent
• Washed Intrauterine Insemination Consent