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) 453-7500

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.

Ovulation induction & IUI

Ovulation induction is a treatment for anovulation (irregular ovulation), an infertility condition in which follicles in a woman’s ovary do not mature and release eggs (ovulate).Intrauterine insemination (IUI) is an artificial insemination procedure in which a doctor transfers sperm collected from a man directly into a woman’s uterus to help her get pregnant.

COVID-19 consent form

COVID-19 has been declared a worldwide pandemic by the World Health Organization. Although the exact mode of transmission is not entirely known, COVID-19 is contagious and is believed to spread by person-to-person contact. Despite taking reasonable preventative measures that are aimed to prevent the spread of COVID-19, an inherent risk of becoming infected with COVID-19 by virtue of proceeding with fertility treatment exists.

FET forms – Please download & review the following documents

Download all FET forms

PGS 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.

Download all egg donor forms

Ovulation induction and IUI forms – Please download & review the following documents

Download all ovulation induction and IUI forms

COVID-19 forms – Please download & review the following documents

Need a different consent form? View all forms.

Not sure which forms to complete? Call us at (401) 453-7500 or contact us online.
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