Below are the forms that ReproTech requires your long-term storage patients to complete prior to cryopreservation for ReproTech account setup. 

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Please note: a separate Addendum to Cryostorage Agreement for potentially infectious clients is no longer required for new accounts. We have incorporated this language into our new storage agreements as of 7/31/20.

Specimen Shipping Liability Protection is available exclusively to ReproTech clients through CNA Financial Corporation, a premier insurance broker in the U.S.

Embryo

• D ACQ-100 Registration – All Tissues
• AC ACQ-100 Embryo Cryostorage Agreement – Single Client Depositor
• O ACQ-100 Embryo Cryostorage Agreement – Client Depositor Couple
• AU ACQ-100 Specimen Transfer to RTL and Medical Data Release Authorization

Oocyte/Ovarian Tissue

• D ACQ-100 Registration – All Tissues
• AA ACQ-100 Oocyte/Ovarian Tissue Cryostorage Agreement
• AU ACQ-100 Specimen Transfer to RTL and Medical Data Release Authorization

Semen

• D ACQ-100 Registration – All Tissues
• N ACQ-100 Semen/Testicular Tissue Cryostorage Agreement
• AU ACQ-100 Specimen Transfer to RTL and Medical Data Release Authorization

Donor Tissue

• D ACQ-100 Registration – All Tissues
• AE ACQ-100 Donor Tissue Cryostorage Agreement – Semen or Oocyte
• AU ACQ-100 Specimen Transfer to RTL and Medical Data Release Authorization

Lab Staff Form:

• B DIS-050 Specimen Transfer Data – Fillable Version – This form must be completed by lab staff, not patients.