These are some common forms patients may need while being cared for at Wisconsin Fertility Institute.  You may fax or e-mail the form, once completed, to our office, if applicable. 

Email: wisconsinfertility@obgynmail.com     Fax:  608-829-0748.

Release medical information TO Wisconsin Fertility Institute
Authorizes a different health care provider to release your medical information to Wisconsin Fertility Institute.  Fax, mail, or hand-deliver this completed form to your health care provider and they will forward your records to our office. Click here to download this form.

Release Medical Information FROM Wisconsin Fertility Institute
Authorizes Wisconsin Fertility Institute to release your medical records from our office to a recipient (yourself, a new health care provider, etc).  We will only copy and release records that were created at Wisconsin Fertility Institute.  If you had records transferred to our office from another office, you will need to contact the original office to release those records.
Click here to download this form. 

IVF Consent Form
This consent form is required to be signed by patients (and their partner if applicable) going through IVF. Click here to download this form.

Consent to Discontinue Storage of Cryopreserved Embryos
This form must be signed by you (and your partner if applicable) in order to discontinue storage of frozen embryos.  If you are planning on discontinuing storage of the embryos, you can choose to discard the embryos, donate them to WFI for research, or donate them to WFI with the intention creating a pregnancy in an Anonymous Embryo Recipient.
Click here to download this form.

Credit Card Authorization
This form is necessary anytime we are going to charge your credit for a service when you are not present. Click here to download this form.

Donor Match Form
Intended Parents selecting an anonymous Egg Donor from the Donor Pool at Wisconsin Fertility Institute should fill out this form when they have chosen a donor. 
Click here to download this form. 

If you have a suggestion of a form you would like to see here, please let us know!