Reproductive Medicine Institute

Below are the forms that ReproTech requires your long-term storage patients to complete prior to cryopreservation for ReproTech account setup.
The “Transfer FROM RTL” forms at the bottom must be completed for patients’ tissues to be transferred back to your clinic and will require patient signatures in the presence of a notary.
Specimen Shipping Liability Protection is available exclusively to ReproTech clients through CNA Financial Corporation, a premier insurance broker in the U.S.
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Reproductive Tissue – Semen, Testicular Tissue, Oocytes, Ovarian Tissue – New Patients

Embryo – New Patients

All Tissues – Transfer FROM ReproTech – Returning to Clinic
These forms must be notarized. If a couple, BOTH patients must sign in the presence of a notary.

Lab Staff form