What is your full name?

How old are you?

What is your email address?

What city and state do you live in?

How long have you been trying to conceive?

When did you first start fertility treatments?

How satisfied have you been with your treatment experience?

How many clinics/providers have you left on your journey?

If you’ve moved on from a fertility doctor or clinic, why did you leave?

If you stayed for more than one treatment, why did you stay?

Anything else you want to share about your experiences or what you value in a fertility doctor?

Are you willing to be contacted to further discuss your experience?