{"id":485116,"date":"2023-07-28T10:00:59","date_gmt":"2023-07-28T17:00:59","guid":{"rendered":"https:\/\/www.seattlespermbank.ca\/?page_id=485116"},"modified":"2023-07-28T10:54:20","modified_gmt":"2023-07-28T17:54:20","slug":"14314-informed-consent","status":"publish","type":"page","link":"https:\/\/www.seattlespermbank.ca\/fr\/14314-informed-consent\/","title":{"rendered":"14314 Informed Consent"},"content":{"rendered":"
<\/strong> (“Patient to be inseminated”) hereby acknowledge and represent as follows:<\/div>\n
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<\/strong><\/td>\nThe undersigned patient seeks to use donated semen from Donor 14314 (Torrey)<\/strong> collected by the Seattle Sperm Bank for reproductive use.<\/td>\n<\/tr>\n
<\/strong><\/td>\nPatient understands that donor has tested positive as a carrier of GJB2-related DFNB1 Nonsyndromic Hearing Loss and Deafness<\/i>.<\/td>\n<\/tr>\n
<\/strong><\/td>\nPatient is aware of the aforementioned exceptions and genetic disease risks associated with each.<\/td>\n<\/tr>\n
<\/strong><\/td>\nPatient agrees to personally assume all risks associated with Patient\u0393\u00c7\u00d6s use of semen samples donated by a Donor that has tested positive as a carrier of GJB2-related DFNB1 Nonsyndromic Hearing Loss and Deafness<\/i>. Patient hereby releases Seattle Sperm Bank and its current and former officers, directors, employees, attorneys, insurers, agents and representatives of any liability or responsibility whatsoever for any and all outcomes, whether currently known, suspected, unknown or unsuspected, arising out of Patient\u0393\u00c7\u00d6s use of donor semen donated by Donor that has tested positive as a carrier of GJB2-related DFNB1 Nonsyndromic Hearing Loss and Deafness<\/i>.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n
Please select ONE of the following boxes:<\/div>\n
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I understand the risks associated with using donor semen donated by Donor 14314 (Torrey)<\/em>\u252c\u00e1that has tested positive as a carrier of GJB2-related DFNB1 Nonsyndromic Hearing Loss and Deafness<\/i>, and I have been offered genetic testing for this condition by Seattle Sperm Bank and I am choosing to DECLINE<\/strong> testing on myself for this condition.<\/td>\n<\/tr>\n
I understand the risks associated with using donor semen donated by Donor 14314 (Torrey)\u252c\u00e1<\/em>that has tested positive as a carrier of GJB2-related DFNB1 Nonsyndromic Hearing Loss and Deafness<\/i>, and I have been offered genetic testing for this condition and have chosen to have myself screened for this condition, as facilitated by Seattle Sperm Bank through the use of genetic testing.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n
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Partner or Spouse Name
\n(if applicable):<\/td>\n		<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n
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\n<\/div>","protected":false},"excerpt":{"rendered":"

(“Patient to be inseminated”) hereby acknowledge and represent as follows: The undersigned patient seeks to use donated semen from Donor 14314 (Torrey) collected by the Seattle Sperm Bank for reproductive use. Patient understands that donor has tested positive as a carrier of GJB2-related DFNB1 Nonsyndromic Hearing Loss and Deafness. Patient is aware of the aforementioned… Read more »<\/a><\/p>","protected":false},"author":13,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-485116","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.seattlespermbank.ca\/fr\/wp-json\/wp\/v2\/pages\/485116","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.seattlespermbank.ca\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.seattlespermbank.ca\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.seattlespermbank.ca\/fr\/wp-json\/wp\/v2\/users\/13"}],"replies":[{"embeddable":true,"href":"https:\/\/www.seattlespermbank.ca\/fr\/wp-json\/wp\/v2\/comments?post=485116"}],"version-history":[{"count":5,"href":"https:\/\/www.seattlespermbank.ca\/fr\/wp-json\/wp\/v2\/pages\/485116\/revisions"}],"predecessor-version":[{"id":485147,"href":"https:\/\/www.seattlespermbank.ca\/fr\/wp-json\/wp\/v2\/pages\/485116\/revisions\/485147"}],"wp:attachment":[{"href":"https:\/\/www.seattlespermbank.ca\/fr\/wp-json\/wp\/v2\/media?parent=485116"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}