Treatment Consent Forms
Consent documents must be signed by the patient and partner (if applicable) prior to each treatment cycle. Consent documents may be returned in the office, faxed to (646) 962-0329 or emailed to firstname.lastname@example.org.
Please feel free to contact the office by telephone with any questions:
- Justine Witzke, PhD, MPH: (646) 962-3235
- Rodriq Stubbs, NP: (646) 962-3276
- Mitasha Joseph, RN, MPA: (646) 962-3382
- Amy Humphreys, MPH: (646) 962-3274
Fertility Preservation (Egg Freezing)
Frozen Embryo Transfer
Frozen Sperm Consents
Frozen Sperm- Andrology Laboratory Storage Consents
These documents are required for each transport of sperm vials from any outside facility.
- Consent to Store Male Partner Sample from another Facility
- Consent to Store Anonymous Donor Sample
- Consent to Store Directed Donor Sample