Kaiser Permanente

Welcome patients of The Center for Reproductive Health at Kaiser Permanente. Below you will find the forms required to set up an account with ReproTech or, at the bottom, the forms needed to have your sperm, embryos or oocytes transferred back to The Center for Reproductive Health in Fremont. 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. Also please note, when completing paperwork to have your specimens RETURNED to The Center for Reproductive Health, the Special Circumstance Release Documentation is only required for those individuals who have either tested reactive for a communicable disease or are missing some of the required testing results. The Specimen Transfer From RTL and Medical Information Release form will require your signatures in the presence of a notary. We look forward to serving you.

Embryo

Semen/Testicular Tissue

Oocyte/Ovarian Tissue

Donor Tissue

All Tissues – Transfer FROM RTL