AGREEMENT AND CONSENT TO PERFORM THERAPEUTIC DONOR INSEMINATION WITH ANONYMOUS DONOR SPERMTherapeutic Donor Insemination Agreement • November 11th, 2013
Contract Type FiledNovember 11th, 2013This document explains the terms under which I, the female patient undergoing insemination, agree and consent to the performance of one or more therapeutic insemination(s) with sperm from an anonymous donor, by the staff of the Massachusetts General Hospital Fertility Center. The Massachusetts General Hospital Fertility Center is signing this Agreement. If I am entering fertility treatment with my husband/partner, my husband/partner’s agreement and consent to participate in this process are also required. My husband/partner’s signature on this document signifies that my husband/partner has read and understands this document and fully and freely agrees to participate in the Fertility Center program as described below.