Step 1 Application Process Checklist
To have your profile submitted to a donor and be considered for any embryos
first submit
Step (1) one checklist
(contact us for the packets of the most up to date version and Step
1 and 2 Checklists)
embryosalive@Gmail.com
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Application/Fee (prior to submission of your profile to a donor)
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*
Disclaimer/Fee/Disclaimer Contract prior to submission of your
profile
to a donor
* you and spouse- if applicable- may notarize separately
(there are 2 notary spots)
Disclaimer:
This page and its content may be updated without notice. Contact EA for
the current
version of step one and step two checklist.
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Dear Genetic Parent/s Letter
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Profile,
photos or collage of family-extended family, inside and outside
of home, and any pets about 6-8 jpg email or mail
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Process
Pre and Post FDA May 25, 2005
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Release of Information
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Disclosure
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*Match Contract
*(due within 48 hours of match and acceptance of match) so be sure
before you apply and accept-there are no refunds for any fees
**( A and R is not sent to donors until these items are in E.A.
office)
***
you and spouse- if applicable- may notarize separately (there
are 2 notary spots)
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*
Mail, scan, or fax: 1. completed application, 2.
disclaimer, 3. release of information 4. disclosure 5. fees
(PayPal
embryosalive@yahoo.com add 10.00 to pick up)
EmbryosAlive@yahoo.com
Fax: 727-489-2427
Step 2
Checklist Dossier:
If you
have a current home study, mail or fax a copy to Embryos Alive 7741
Pfeiffer Road, Cincinnati, Ohio 45242-5020 Fax 727-489-2427
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If you
do not have a current or pending approved homestudy, please
provide the following dossier or documents in order to complete and
process a match.
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9b.
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Compile,
organize by corresponding number, and use either sticky notes or
numbers on each document.
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10.
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Letter of
Understanding of Process
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11.
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Physician’s letter
(stating you could carry a child to term)
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12.
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Criminal
History (selection.com)
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13.
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Affidavit
of Criminal History
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14.
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Embryo
Agreement and relinquishment (email us) (A and R)
*
you and spouse- if applicable- may notarize separately (there
are 2 notary spots)
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15.
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4
References (non-relative)
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16.
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Proof of
income (pay stub/current income tax/employer letter)
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17.
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Protocol
awareness letter (thawing protocol may not be available)
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18.
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Home
Owners Insurance (copy)
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19.
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Health
Insurance (copy)
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20.
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Life
insurance (copy)
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21.
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Will (or
letter regarding the will) notarized
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22.
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BMV or
DMV (Bureau of Motor Vehicles/Department of Motor Vehicles)
history
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23.
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Copy of
drivers license/s
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24.
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Sex Offender Clearance
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25.
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Counseling Awareness Letter
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26.
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Quality
Survey
Email, mail or fax a copy of your homestudy to:
Embryos Alive
7741 Pfeiffer Road
Cincinnati, Ohio 45242-5020
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