Below are the forms that ReproTech requires your long-term storage patients to complete prior to cryopreservation for ReproTech account setup.
 
Specimen Shipping Liability Protection is available exclusively to ReproTech clients through CNA Financial Corporation, a premier insurance broker in the U.S.
 
Each time you access this webpage, please clear your browser cache to ensure you are viewing the most recent version of our forms. Learn how to clear your cache: https://its.uiowa.edu/support/article/719
 
Reproductive Tissue – Semen, Testicular Tissue, Oocytes, Ovarian Tissue – New Patients

• English:
  • SINGLE CD – Reproductive Tissue Forms Packet A02
  • COUPLE – Reproductive Tissue Forms Packet A17
  • MINOR – Reproductive Tissue Forms Packet A03
• Spanish:
  • SP-SINGLE CD – Reproductive Tissue Forms Packet – A02-S
  • SP-COUPLE – Reproductive Tissue Forms Packet A17-S
  • SP-MINOR – Reproductive Tissue Forms Packet A03-S

 
Embryo – New Patients

• English:
  • COUPLE – Embryo & Donor Embryo Forms Packet A16
  • SINGLE CD – Embryo & Donor Embryo Forms Packet A01
• Spanish:
  • SP-COUPLE – Embryo & Donor-Embryo Forms Packet A16-S
  • SP-SINGLE CD – Embryo & Donor-Embryo Forms Packet A01-S

 
Lab Staff form

• Specimen Transfer Data – FILLABLE – DIS-050  Fillable version – This form is completed by lab staff, not patients