Form

Confidential Consultation Request Form

Your privacy is important to us. All information provided is protected under applicable data protection laws and medical privacy regulations.

First Name

Last Name

Email*

Mobile Phone Number

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Preferred Contact Method

Phone

Preferred Time to Contact

Select the time that works best for private, uninterrupted conversations. We understand the sensitive nature of fertility discussions and ensure complete privacy during calls.

Treatment Interest

ℹ️ Let us know which fertility solutions interest you. We offer customized treatment plans including IVF, egg donation, sperm donation, gender selection, and embryo donation - all within Cyprus's legal framework. Your selection helps us prepare relevant information for your consultation, though all options can be discussed in detail during your call. No need to share medical details now - we'll guide you through everything step by step. Are you interested in: □ IVF Treatment □ Egg Donation □ Sperm Donation □ Gender Selection □ Embryo Donation □ Other (please specify)

IVF SUPPORT SERVICES Privacy and Data Protection Notice

We are committed to protecting your privacy and handling your information with care. Here's how we'll use and protect your information:

Data Usage: Your personal information will be used to:
• Process your consultation request
• Provide requested fertility treatment coordination services
• Communicate about your care and appointments
• Send relevant treatment information and updates (with your consent)

Medical Information: Any medical data you share is protected under strict healthcare privacy regulations and will only be shared with your designated medical providers with your explicit consent.

Your Rights: You have the right to:
• Access your personal data
• Request corrections or deletions
• Withdraw consent at any time
• Request data portability
• File a complaint with data protection authorities

Data Protection: We implement robust security measures to protect your information, including encryption and secure data storage.

I agree to receive treatment-related communications from IVF SUPPORT SERVICES.

You can unsubscribe from these communications at any time. For more information on how to unsubscribe, our privacy practices, and how we are committed to protecting and respecting your privacy, please review our Privacy Policy.

By submitting this form, you consent to:

The storage and processing of your personal data as described above The transfer of your data to Cyprus for treatment coordination (with appropriate safeguards) The processing of sensitive medical information when necessary for your care