ReproTech

Contact RTL to obtain copies of the following forms to open an account and to authorize the transfer of ovarian tissue.

1. Registration - This form gives us information about the patients and identifies the method of payment of fees.
2. Medical History - This form gives us information on the patient’s medical history and the reason for ovarian tissue storage (cryobanking).
3. Ovarian Tissue Cryostorage Agreement - This form defines the terms and conditions of storage of cryopreserved ovarian tissue.
4. Specimen Transfer To RTL and Medical Data Release Authorization- This form obtains the patient's consent for the release of medical data, as well as the consent to transfer the ovarian tissue to RTL for storage.
5. Addendum to Ovarian Tissue Cryostorage Agreement - This form is necessary only for patients who have tested reactive for HIV, Hepatitis B, Hepatitis C, HTLV I&II, or other sexually transmitted diseases. This form defines additional terms and conditions of ovarian tissue storage and shipping that apply to potentially infectious tissue.