Sperm Banking Forms
Storage account set-up
PRESERVE kit forms
Other forms
**DUE TO COVID-19, CAN-AM HAS SUSPENDED ALL SPERM BANKING SERVICES UNTIL FURTHER NOTICE**
Completed, signed documents can be returned to CAN-AM at the following:
Scan/email to: info@canamcryo.com
Fax: 905-524-3936 or Toll free 1-877-772-6387
Mail: 102-1057 Main St. W., Hamilton, ON L8S 1B7
Storage account set-up
Blood Testing Request Form
Blood testing must be completed before sperm can be stored. Provide this list of required testing to your family doctor or oncologist to have testing completed before your first storage appointment.DOWNLOAD PDF
Consent and Storage Agreements
Please complete the following document to store your sperm, eggs or embryos.Client Depositors banking their own sperm (Self-banking)
COMPLETE ONLINE
Storage Clients storing donor sperm or donor eggs (Single Client)
COMPLETE ONLINE
Storage Clients storing donor sperm, donor eggs or embryos (Client Couples)
COMPLETE ONLINE
PRESERVE kit forms
PRESERVE Kit Instructions
Instructions to collect your sperm for personal banking, and ship them back to CAN-AM for freezing and storage.DOWNLOAD PDF
Specimen Collection Documentation
Complete the details of your sperm sample collection. You may upload a copy of one piece of identification by completing the form online. Or you may email a copy directly to info@canamcryo.com.DOWNLOAD PDF COMPLETE COLLECTION DOCUMENT ONLINE
Other forms
Consent for Release and Transfer of Stored Sperm
This form is for clients with sperm stored at CAN-AM who want to some or all of their sperm to another facility. Complete this consent and return to CAN-AM to transfer your sperm to your fertility clinic. This form is NOT for the transfer of donor sperm from storage.DOWNLOAD PDF
Consent for the Disposal of Stored Sperm
This form is for clients with sperm stored at CAN-AM who want to terminate their storage account and discard their sperm. Complete this consent and return to CAN-AM to dispose of your unneeded stored sperm.DOWNLOAD PDF