We are proud to offer assistance to those in need.

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.

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!

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

CryoGam Colorado, LLC | 2216 Hoffman Dr. Unit B, Loveland, CO 80538 | Main: 800-473-9601 | Fax: 970-461-7800 | Contact Us