The process to open an account will depend on the physician's financial responsibility, as explained below. An account must be opened before you or members of your staff can order a donor specimen.
Adobe Reader is required to download the necessary documents to open an account. To receive these documents by mail, please contact our Physician Services Department at 877-422-5279.
If you or members of your staff wish to place orders for your patients and you will be financially responsible for all charges in connection with services provided by California Cryobank, Inc.:
- Complete the Statement of Physician Responsibility
- Mail or fax to:
California Cryobank, Inc.
11915 La Grange Avenue
Los Angeles, CA 90025
Fax: (866) 625-7336 US and Canada / (310) 826-1605 International - Call and place specimen order
If you or members of your staff wish to place orders for your patients but you want your patient to be financially responsible:
- Patient must open an account (completing Purchase / Storage Agreement) online
- Physician completes the Authorization for Release of Semen (A1)
- If patient does not open online account, they must download and sign the Purchase and Storage Agreement and mail or fax to:
California Cryobank, Inc.
11915 La Grange Avenue
Los Angeles, CA 90025
Fax: (866) 625-7336 US and Canada / (310) 826-1605 International - Physician may only place specimen orders over the phone
- Physician must have patient's information (including account # and answer to security question)
- Patient's credit card will be charged at the time of purchase