Forms for Donor Egg Recipients

 

Access to Egg Donor’s Adulthood Photos

Fairfax Eggbank provides professional adulthood photos of our egg  donors, which you can access upon completion of a confidentiality agreement form. Complete and submit the following:

CON-304 Patient Photo Agreement

Please allow for up to 1 business day for a response upon submission.

Donor Egg Advanced Purchase and Storage

The oocyte storage agreement gives you the option to purchase the donor egg cohort in advance and keep it in storage at Fairfax EggBank until it is ready to be shipped. You will need your clinic’s consent in order to be able to exercise this option. This may be a good option for you if you:

  • Wish to purchase more than one cohort of donor eggs at a time, and want to store the extra cohort(s) onsite until you need them for a treatment cycle, or
  • See a donor who you like but don’t plan on cycling for a few months

FOR-121D Fairfax EggBank Donor Oocyte Storage Client Agreement:

 

Donor Match Confirmation [To Be Initiated By Clinic Personnel Only]

Once you are ready to move forward with a donor egg purchase, your coordinator at Fairfax EggBank will initiate a Donor Match Confirmation with your clinic. This documentation enables your clinic to acknowledge and authorize the donor egg purchase, and for your clinic to indicate the shipping and warming date.

[Recipient Purchase/Patient Bill] FOR-121D Fairfax EggBank Donor Match Confirmation

This version is for clients who pay Fairfax Eggbank directly for the cost of the donor egg cohort(s).

[Clinic Bill] FOR-121A Fairfax EggBank Donor Match Confirmation

This version is for clients who pay their clinic for the cost of the donor egg cohort(s).