It’s easy to refer a patient to us. You can either print out and fax back the referral form to us (click here to download the form with instructions); or, you can complete our easy online form below. Please note this form is for  patients who are attempting to become pregnant (using their eggs/uterus, IUI, IVF, donor eggs, or gestational carrier), or patients who are considering freezing their own eggs or embryos for the future. If you are referring a patient for semen analysis please use our Semen Analysis Requisition form.

We also offer numerous referral materials; click here for the complete list and to order.

Center for Advanced Reproductive Services On-line Referral Form

PLEASE NOTE: For patients in need of oncofertility services, we have a dedicated referral process for egg freezing oncoferility services to ensure expedited care for cancer patients. Please email oncofertility referrals to [email protected] or by fax to 860-261-0386. Please DO NOT use the online referral form for patients in need of oncofertility services. 

For patients in need of sperm freezing, call any Center location to speak with someone about making an urgent male oncofertility appointment at one of our offices.