Forms and Agreements

Origin Forms and Agreements

Digital Order Form - When complete, please email to info@originspermbank.com

Donor Specimen Purchase and Terms of Use Agreement

Donor Specimen Shipment Information for the Patient

Live Birth Report

Fairfax and CLI Forms

Fairfax and CLI Physician Terms of Use

Fairfax and CLI Canadian Terms of Use - English (On-Line Submission)

Fairfax and CLI Canadian Terms of Use - English (Document)

Fairfax and CLI Canadian Terms of Use - French (On-Line Submission)

Fairfax and CLI Canadian Terms of Use - French (Document)

Instructions for Semen Identification, Thawing, and Specimen Quality Standards - English

Instructions for Semen Identification, Thawing, and Specimen Quality Standards - French

Pregnancy Pledge Verification Form

Identity (ID) Option Birth Registration

Specimen Quality Complaint