Prior to shipping of donor sperm, our Purchaser Semen and Storage Agreement needs to be completed.

For Patients with a Partner or Spouse, we recommend both parties initial and sign the form. Enter both names and email addresses on the form. The Patient should initial and sign before submitting it to the Partner or Spouse for their initials and signature.

For single customers, simply leave the second Name and Email blank.

Upon submission of the completed form, you will receive an email confirmation and an emailed copy of the signed form to keep for your records.

The form can be signed and submitted electronically:

Please use the same email address you use to logon to your sussexspermbank.com account when signing any electronic forms. This helps us ensure the form is correctly assigned to your account.

Only Submit This Form One Time. It will be saved for future orders and shipments.

• Purchaser Semen and Storage Agreement – Electronic Signature

This form can also be printed, signed and faxed to: (206) 466-4696 or scanned and emailed to [email protected].

• Purchaser Semen and Storage Agreement PDF

If samples are shipped to your home or picked up at our office please have a physician or other licensed healthcare provider sign our Clinical Release Form.
If you are a having your order shipped within NY State, this release form is required for all orders and can only be completed by your physician.

This form can be digitally signed by your physician, or printed, signed, and returned to us via fax at (206) 466-4696 or scanned and emailed to [email protected].

• Email Clinical Release to your Provider
• Download Clinical Release PDF
• Online Form- Clinical Release 

You can also mail any of this signed paperwork to:

Brighton Fertility
4915 25th Avenue NE, Ste 204
Seattle, WA 98105