Outreach Health Services Client Forms

 

Orders shipped to Canada are placed through our distributors. Please contact Outreach Health Services directly to place your semen order.

Other forms and brochures may be requested from our Client Service Specialists. Please contact us if you need assistance.

 

Forms/Policies in French

Physician Only Forms- click here

Important Policies

  • CLI and Fairfax Cryobank limit the total number of births outside the US for any donor based on the application of several criteria. Specifically, a donor's sales will cease when either of the following criteria is reached:

    1. Maximum of 15 families (children from the same donor living in one home) reported outside the US

    2. Families who have children by the same donor will be sold additional donor units, if available, as 'Sibling Pregnancies Only' units.

    3. In addition, we also monitor the reported location of births and limit the geographic distribution of a donor consistent with the guideline of the American Society of Reproductive Medicine (ASRM).

    4. In order to help us monitor the number of births associated with any donor, it is important that everyone be diligent in reporting births to us. Please go to the pregnancy reporting page for CLI  or Fairfax Cryobank Pregnancy Report Formor call us with your information.

    5. If a donor has reached his maximum limits on families or total sales, then reactivation of that donor may be available for sibling pregnancies. (Reactivation means that a donor can be asked to provide additional samples after he has left the program. The donor must first agree to be reactivated and if he does the client agrees to pay all costs which typically exceed several thousand dollars.)

     

 

Fairfax Cryobank Brochures available for download:

 

Cryogenic Laboratories, Inc Brochures available for download:

 

Monthly e-news

 

Video about our Donor Sperm Services