Thank you for entrusting your specimen to the Men’s Fertility Laboratory and NY Cryo! Just a bit more information we need before we can analyze your specimen. If you cannot complete this form at this time please click ‘Save and Continue Later’ below and we will email you a link to use to return to this page.
We will need you to upload the prescription from your referring healthcare provider for the test. You can take a picture of it and upload from your desktop or mobile device. If you have difficulty uploading your prescription or you do not have a prescription please call us and press “Save and Continue” below to have a link back to this page..
After you complete this form we will email you a Specimen Production Form to complete after you produce your specimen.
PLEASE NOTE: We are required to have a Prescription submitted and a Specimen Production Form completed before we can accept your specimen for analysis. Please also read the Procedure for Semen Specimen Collection prior to your giving a specimen.
If you have any questions please call us at 516-487-2700.