Welcome to all institutions who have implemented Ovarian Tissue and/or Testicular Tissue Cryopreservation protocols. ReproTech has set the industry benchmark for safe, secure cryostorage for over 30 years. All five of our locations (Connecticut, Florida, Minnesota, Nevada or Texas) feature Disaster-Proof Safe Storage Rooms.
Below are the forms required by patients to set up a long-term storage account with ReproTech. Please have your patients/families complete the applicable forms before tissue retrieval and return to the ReproTech location that serves your facility. Please feel free to reach out to Jeanne Blank with questions about account set-up or forms at firstname.lastname@example.org or 651-489-0827.
Specimen Shipping Liability Protection is available to ReproTech clients through CNA Financial Corporation, a premier insurance broker in the U.S.
ReproTech offers its Verna’s Purse Financial Assistance Program for qualified patients.The eligibility criteria and application are included in the list of forms below. Please note that approval is not guaranteed, an application must be completed and submitted by each qualifying patient to ReproTech, who will advise if approved.
Reproductive Tissue – Ovarian Tissue, Testicular Tissue, Oocytes, Semen – New Patients
- Arabic (patients must fill out their information in English):
Lab Staff form
- Specimen Transfer Data – FILLABLE – DIS-050 Fillable version – This form is completed by lab staff, not patients