Fertility Answers - Helping Build Families

Fertility Answers Media Consent

We can’t wait to see that baby!

Thank you for allowing us to be a part of your journey to a family! We love seeing the babies we helped create and are so happy for your success.

By completing and signing this form, you are giving Fertility Answer permission to add your baby’s photo to our online baby book and to post on our social media sites.

Please sign the following media release when submitting media (photographs, images, videos, testimonials, letters, birth announcements) to Fertility Answers. Please identify the “subject” of the media, that is who can be identified in the media, and their date of birth. When finished completing the form and signing, please press Submit so we can save the release to your Fertility Answers patient file.

 

Fertility Answers Media Release

Patient Date of Birth(Required)
Drop files here or
Max. file size: 50 MB.
    Subject Birthdate(Required)
    Subject Birthdate
    Date Signed(Required)