Shared Help Request Form

The Shared Help Program is designed to help make fertility testing and treatment more affordable, by offering discounts to patients who have no insurance coverage for procedures and services needed and limited personal resources to cover the out-of-pocket expenses. Since the inception of the program in late 2008, 70% of Shared Help applicants have been approved for discounted treatment. Please complete this form to speak to our Shared Help Liaison today about how this program can help you have a baby or call 1-888-348-5599.