Become a Freeze-verified™ clinic!

We're on a mission to make choosing a clinic easier for women who want to freeze their eggs! Many of the fields on this form are optional, but we encourage you to fill out as much information as you can in order to give the Freeze community the most complete information possible to make a decision on where to freeze.

I would like to:
Your Name *
Your Name
We'd like to know who submitted this form so we have a point of contact if we need to confirm any information. Your name will not be displayed publicly.
Your Phone
Your Phone
Your business phone - a direct line, if possible. This will not be displayed publicly, but will be used for communication if the Freeze team has additional questions on your profile.
Initial Consultation
Please assuming that pricing is for a cash paying/non-insured patient interested in a single cycle of egg freezing.
Before a woman has paid or committed to a cycle.
e.g. If you charge $300 for an initial consultation, and $10,000 for a cycle, would any of the $300 that the woman spent on the initial consult be applied as a credit to the $10,000 cycle price? Please clarify if all, part, or none of the cost would be applied.
Are the costs for these blood tests included in in the price of the first consultation? *
Remember to assume that this is a cash-paying, uninsured patient.
Please provide either a total amount for all tests that were listed above, or list the individual cost for each test. Assume that this is a cash-paying, uninsured patient, completing the tests in your office.
Do you require an ultrasound before a cycle starts? *
If it is NOT included in the price of the first consult, how much does it cost? Assume this is a cash-paying, uninsured patient. If an ultrasound is not required before a cycle starts, leave this field blank.
Examples may include additional consults, additional cost for longer appointments, equipment fees, fees for in-office venipuncture or laboratory fees that are not included in the lab test cost above, etc. Please list, including pricing (provide range if pricing is variable) and whether this is required cost for all patients, or optional. (If any costs are optional, please explain in what circumstances it may be recommended or required.)
Single Cycle
Please assuming that pricing is for a cash paying/non-insured patient.
If not, how much (please specify if this is an exact amount, approximate or range) additional does this cost for cash-paying, non-insured patients when performed in the office for the entire cycle?
If not, how much (please specify if this is an exact amount, approximate or range) additional does this cost for cash-paying, non-insured patients for the entire cycle?
If not, how much (please specify if this is an exact amount, approximate or range) additional does this cost for cash-paying, non-insured patients for the entire cycle?
If not, how much (please specify if this is an exact amount, approximate or range) additional does this cost for cash-paying, non-insured patients?
Examples may include monitoring costs, additional cost for longer appointments, equipment fees, facility fees, etc. Please list, including pricing (provide range if pricing is variable) and whether this is required cost for all patients, or optional. (If any costs are optional, please explain in what circumstances it may be recommended or required.)
Storage & Follow-up
Please assuming that pricing is for a cash paying/non-insured patient.
Does your clinic offer onsite storage? *
If yes, how many months are included in the single cycle price?
If you do not offer onsite storage, leave this field blank.
Examples may include additional follow-up consults, blood work, ultrasounds, etc. Please list, including pricing (provide range if pricing is variable) and whether this is required cost for all patients, or optional. (If any costs are optional, please explain in what circumstances it may be recommended or required.) Please exclude costs for when a patient may come back to unfreeze her eggs.
If so, please explain these discounts and any exclusions or terms that are associated with them. (For example, $1,000 discount on two cycles if a woman prepays for both; $500 discount if a woman comes back for a second cycle in the next six months, etc.)
Additional Clinic Information
If you have a separate site specifically for egg freezing patients, please provide that.
http://
We like to be social! We'll follow you from our accounts, and link to your social media accounts from your listing on the Freeze site so our community can find you there, too.
Online, by phone, or either? Please provide phone number, online form link, and/or email address that patients should use to book an initial consult.
What is your clinic's mailing address? *
What is your clinic's mailing address?
Do you see patients at this address? Do you have additional locations? *
If you have more than one location where you see patients, the Freeze team will email you to collect the addresses of your additional locations.
Would your clinic be willing to discuss offering a discount or promotion to the Freeze community for egg freezing at your clinic?
Almost done! Your logo
Last but not least, please send a high-resolution version of your clinic's logo to hello@freeze.health so we can include it with your profile.