Patient Treatment Consent Forms Selection Tool
Please select all services you may pursue for fertility treatment. The appropriate consent forms will appear at the end of the page (scroll down past the checkbox section).
Download each document, review and bring the paperwork with you to your appointment. If you have any questions about your forms, please contact us at (401) 441-5336.
In vitro fertilization (IVF)
IVF is an assisted reproductive treatment for a range of male & female infertility issues. During IVF, sperm and an egg are combined in a laboratory and the resulting embryo is placed in a woman’s uterus to achieve pregnancy.
Frozen embryo transfer (FET) and frozen embryo storage
Individuals with embryos from an IVF cycle or from a donor can elect to have those embryos frozen until they wish to use them in a future IVF cycle (in which the selected embryos are thawed and transferred to the woman’s uterus).
Preimplantation genetic screening (PGS)
PGS is a type of genetic testing performed during IVF that evaluates embryos for chromosomal errors that can cause miscarriage or birth defects. PGS may be recommended for women who have had multiple miscarriages, are older than 35 or have experienced previous failed IVF treatments, as well as for those with a family history of conditions caused by chromosomal errors.
Preimplantation genetic diagnosis (PGD)
PGD is a type of genetic testing performed during IVF that detects single-gene disorders in embryos that can cause conditions such as muscular dystrophy, sickle cell anemia, cystic fibrosis and Tay-Sachs. PGD may be recommended for individuals with a family history of certain genetic conditions.
Egg donation
Egg donation is when a woman donates some of her eggs to another woman or couple who cannot get pregnant using their own eggs. Women with poor quality eggs and LGBTQ individuals and couples may choose to receive donated eggs for an IVF cycle.
Sperm donation
Sperm donation is when a man donates his sperm for use in assisted reproductive treatments, such as intrauterine insemination or IVF. Men or couples with male infertility conditions (such as low sperm count or quality), single women and lesbian couples may choose to use donated sperm in a number of fertility treatments to become pregnant.
Gestational carrier (surrogacy)
Gestational carriers carry a pregnancy for another woman or couple who cannot safely carry a pregnancy on their own. Male individuals or couples can also use a gestational carrier to have a child with one partner’s genetics.
Egg or embryo freezing for fertility preservation
Women can elect to freeze their eggs or embryos before undergoing certain medical treatments that can cause infertility, such as chemotherapy, or to preserve their future fertility. Frozen eggs & embryos can be stored long-term until the woman wants to use them in an IVF cycle.
LGBTQ assisted reproduction
Many LGBTQ couples and individuals use fertility treatments to assist in building their families. LGBTQ family planning usually involves third-party reproduction help in the form of donated eggs, embryos and/or sperm, and in the case of gay male couples, the use of a gestational carrier to carry the pregnancy.
IVF forms – Please download & review the following documents
- Consent for IVF
- Conset for intracytoplasmic sperm injection (ICSI)
- Consent for embryo handling & cycle initiation
- Consent for embryo cryopreservation
- Consent for embryo storage
FET forms – Please download & review the following documents
Download all FET formsPGS forms – Please download & review the following document
PGD forms – Please download & review the following document
Egg donation forms – Donors, please download & review either the known or anonymous donor forms. Egg donor recipients (intended parents) should download & review either the known or anonymous recipient forms.
- Consent for anonymous egg donor (recipient form)
- Consent for anonymous egg donor (donor form)
- Consent for known egg donor (recipient form)
- Consent for known egg donor (donor form)
Sperm donation forms – Please download & review the following documents
- Consent for use of anonymous donor sperm (for recipient)
- Consent for use of directed donor sperm - subsequent use
Gestational carrier forms – Please download & review the appropriate documents
- Consent for use of gestational carrier (for carrier)
- Consent for use of gestational carrier (for intended parents)
Egg freezing & embryo freezing forms – Please download & review the appropriate documents
- Consent for egg retrieval and freezing
- Consent for storage of frozen eggs
- Consent for embryo freezing
LGBTQ assisted reproduction forms – Please download & review the appropriate third-party reproduction documents
- Consent for anonymous egg donor (recipient form)
- Consent for anonymous egg donor (donor form)
- Consent for known egg donor (recipient form)
- Consent for known egg donor (donor form
- Consent for use of anonymous donor sperm (for recipient)
- Consent for use of directed donor sperm - subsequent use
- Consent for use of gestational carrier (for carrier)
- Consent for use of gestational carrier (for intended parents)
Need a different consent form? View all forms.
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