A cancer diagnosis can be an overwhelming financial burden. CryoGam has partnered with LIVESTRONG to offer a Fertility Discount Program for qualified male patients facing cancer treatment.

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What do I need to apply?

 

The application consists of three parts:

 

1.) Patient Authorization and Consent Form - to be completed and signed by the patient and/or patient's parent or guardian if under age 18

2.) Oncologist Referral and Certification Form - to be completed and signed by his oncologist

3.) The patient's or patient's parent's/guardian's most recently submitted 1040 Federal Tax Return Form

 

How do I get started?

 

-  Click here for the online application!

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 - Please visit our Resources Page to find out more information on infertility and cancer.