Intended Parent Questionnaire
Before you fill out and submit this form, thereby agreeing to our Terms of Use at: https://www.dropbox.com/s/v09tlwmc1twi51v/Terms%20of%20Use%202018.pdf?dl=0

We have over 100 repeat egg donor who have donated before and a total of nearly 400 college educated egg donors. Without a password, you can preview a snapshot of the Fertility Bridges Egg Donor Database Donor Database file here:
https://www.dropbox.com/s/0pw7e27va9v8eol/Excel_ED%27s_Sept_2018.xlsx?dl=0

Please call Fertility Bridges' main office at 888-482-7434 or email contact@fertilitybridges.com with any questions you may have prior to submitting this form. It is our pleasure to help you in any way.

Email address *
First Name *
Your answer
Last Name *
Your answer
Phone *
Your answer
Partners' Name or "Single Parent" *
Your answer
Relationship Status *
City *
Your answer
State *
Your answer
Country *
Your answer
Age *
Your answer
Partner's Age *
Your answer
Fertility Clinic Name *
We have worked with over 150 Fertility Clinics across the country and can make a recommendation if you are looking at clinic options. Write N/A if you haven't selected one yet.
Your answer
Fertility Clinic City *
Your answer
Fertility Clinic State *
Your answer
Fertility Doctor *
Your answer
Egg Donor Characteristics
Characteristics you are looking for a in a Donor, such as: color of eyes or hair, height or ethnicity. If you send a photo of yourself to jessica@fertilitybridges.com, we will search through our Donors for you and send the women we think are a potential match with your physical traits and your provided criteria. We will include Donor profiles who aren't available on the website yet.
Your answer
Surrogacy *
Required
Anonymity
Attorney
Do you have an Egg Donor Attorney? Most IVF clinics require a legal clearance letter from an attorney before they will do your egg donor cycle.
How did you learn about Fertility Bridges? *
Donor Fees
What Donor fee are you able to afford? We have over 400 Donors ranging in fees from $3,500 to $10,000+. Repeat Donors with good success often have higher fees, though you may save money on screening costs. We provide Donor suggestions so they fit within your affordability range. (* We do have special programs for our lower income clients who qualify.)
Donor Notifications
Would you like to know of potential Donors, who fit your characteristics, just prior to being entered into our Database? This may give you the opportunity to match with a Donor before others see her profile online. Donors with favorable characteristics often match the first day and develop a waiting list quickly. Donor alert emails will be sent to the email you listed above, unless you write another email in the "other" section below.
Client Contact *
Please check both boxes below.
Required
Terms of Use *
By submitting this form, you agree to the Fertility Bridges Terms of Use for using our online Egg Donor Database located at: https://www.dropbox.com/s/v09tlwmc1twi51v/Terms%20of%20Use%202018.pdf?dl=0
Required
Directions for Using the Online Database *
I agree to carefully follow the directions for logging in to the Egg Donor Database provided in my welcome email and at this link: https://www.dropbox.com/s/v09tlwmc1twi51v/Terms%20of%20Use%202018.pdf?dl=0
Required
Database Interactive Anonymity *
You are welcome to ask Donors questions as long as you anonymously identify yourself, such as "IP from Chicago".
Required
Dono Availability *
It is best to start your egg donation search with at least 10 Egg Donor candidates in mind. Due to the busy schedules of many Donors, especially repeat Egg Donors, you may not be able to secure your first choice of Donor for the schedule you want. If timing is very important to you, and you don't want to wait 6 months for your 1st choice Donor to become available, then we recommend that you expand your horizons and think about matching with other lovely amazing Donors who are available.
Required
Agency Fees *
Fertility Bridges is a third party fertility consulting agency that can help you find an Egg Donor and coordinate your Egg Donor cycle with your fertility clinic. After you have selected an available Donor in our database and she completes her agency agreement for your match, we will then request a $3,000 cooridnation fee from you. An additional fee is due once your selected Donor is medically screened and cleared by your fertility clinic to proceed. The initial $3,000 fee covers our consulting time with you during your match selection process and one Egg Donor cycle coordination with a Donor in our program or in another program.
Required
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