You may download and print out our forms to complete prior to your first appointment with us. It is not necessary that you do this, however, it will save you some time when you come into the office.
Also, just a reminder, bring your insurance cards and a list of your medications with you.
Embryo Storage Termination
Instructions for completion of termination form : Initial your choice for your pre-embryos to either dispose, donate to research, or donate to anonymous recipient. Both patient and original partner must elect the same choice and initial and sign the consent.
At this time, there has been no documented change in embryo quality or potential for survival after many years in storage. Current industry philosophy is that the embryos may be stored indefinitely with no appreciable impact.
If you have chosen to donate your pre-embryos to an anonymous recipient, you will need to have lab work drawn at the expense of Virginia IVF & Andrology Center and a medical and genetic questionnaire will need to be completed by each partner. Another packet of information and the necessary forms will be sent to you under separate cover if you choose this option. You may contact our Donor Coordinator at 804-323-9980 if you have further questions regarding this program.
Please be advised that billing will not cease until such time as we have received a fully executed consent. Remember that our billing is retroactive; so you may receive a bill after you have forwarded your consent form.
Sperm Storage Termination
Instructions for completion of termination form : Complete form. Signature must be notarized if mailing form to our office. If bringing form in person, signature may be witnessed by our staff.
Please be advised that billing will not cease until such time as we have received a fully executed consent. Remember that our billing is retroactive; so you may receive a bill after you have forwarded your consent form.
