Consent Forms

Downloadable PDFs

1. Consent to treatment with assisted reproductive technologies (ART Consent)
2. Consent to freezing and storage of human embryos
3. Side effects of gonadotropins
4. Consent to frozen embryo transfer
5. Consent to shipment of frozen embryos to, and short term storage at FFC
6. Disposition of frozen specimens currently stored at the Family Fertility Center
   1. Disposition of frozen embryos currently stored at the Family Fertility Center
   2. Disposition of frozen sperm, epididymal aspirate or testicular tissue currently stored at FFC
   3. Disposition of frozen eggs currently stored at FFC
7. Consent to be a gestational surrogate
8. Consent to freezing and storage of human eggs
9. Consent to donate human embryos for reproductive purpose
10. Consent to accept donated human embryos for reproductive purposes
11. Consent to artificial insementation using sperm from intimate partner
12. Consent to intrauterine insemination (IUI) with donor sperm
    1. For Couple
    2. For Individual
13. Consent to short term storage of donor gametes at Family Fertility Center
    1. Donor sperm
    2. Donor eggs
14. Consent to freezing and short term storage of semen at FFC (backup purpose only)
15. Consent to freezing and short term storage of semen, epididymal aspirate and/or testicular biopsy tissue at FFC
16. Consent to donate sperm to designated recipient
17. Consent to donate sperm for quality control use only
18. Consent Forms for Long Term Storage at Reprotech
    1. Go to Reprotech.com
    2. Click the link “For Customers +” shown on the top of the home page
    3. From the pull down menu, select “Customer Portal“.
    4. A new page will appear. On the left hand side of the new page, look for where it says: New patient? register here
    5. Click register here. Follow the online directions to complete your Consent Form for Storage at Reprotech.
    6. Call Reprotech at 651 489 0827 if you need help with its patient portal.

19. 19. Consent to embryo biopsy for pre-implantation genetic testing
    20. Consent to Telemedicine Services

Forms

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