Call (703) 920-3890
Book Appointment
Locations
a-heart
Created with Sketch.
Patient Portal
-->Toggle navigation
theicons.co/svg/common-01
Created with Sketch.
Treatments
Stimulated IVF
Donor Egg IVF
Ovulation Induction
Intrauterine Insemination (IUI)
Gestational Carrier
Frozen Embryo Transfer (FET)
Fertility Preservation
Become an Egg Donor
Fertility Assessment
Egg Cryopreservation
Preimplantation Genetics
Life After Cancer
LGBTQ Fertility
Our Practice
Our Doctors
Our Staff
Our Laboratory
Success Statistics
Resources
New Patient Information
Out of Town Patient Information
Financial Information
Glossary of Terms
Insurance Information
Physician Referrals
Grow Your Family – Free Fertility Webinar
Dominion Fertility Support Group
Videos
Blog
Become an Egg Donor
Treatments
Stimulated IVF
Donor Egg IVF
Ovulation Induction
Intrauterine Insemination (IUI)
Gestational Carrier
Frozen Embryo Transfer (FET)
Fertility Preservation
Become an Egg Donor
Fertility Assessment
Egg Cryopreservation
Preimplantation Genetics
Life After Cancer
LGBTQ Fertility
Our Practice
Our Doctors
Our Staff
Our Laboratory
Success Statistics
Resources
New Patient Information
Out of Town Patient Information
Financial Information
Glossary of Terms
Insurance Information
Physician Referrals
Grow Your Family – Free Fertility Webinar
Dominion Fertility Support Group
Videos
Blog
Become an Egg Donor
Learn More About Fertility Care Since Roe V Wade Was Overturned:
Get Involved and Take the #SaveIVF Pledge
Physician Referral Resources
Forms
Fertility Referral Pads
Get Your Treatment Team Right The First Time
Contact Dominion Fertility Today
Where do you live?
*
Please Select
US Resident
International Resident
How Can We Help You?
*
Please Select
Schedule an appointment
Returning Patient
Interested in learning more about
Are you planning to use insurance or a family building plan?
*
Yes
No
Insurance Card Upload
Accepted file types: jpg, jpeg, png, gif, pdf, Max. file size: 300 MB.
Please upload a copy or photo of your insurance card.
Our Services
*
General Infertility + Testing
Treatment Costs + Financing
Intrauterine Insemination (IUI)
In Vitro Fertilization (IVF)
Egg Freezing
Genetic Testing
Egg Donor Program
Egg Bank
Donor Sperm
Surrogacy
Please check all that apply.
Messaging for returning patient goes here. Add link to new portal. Please do not bother filling out the rest of the form.
How did you hear about us?
*
Please Choose
Google / Web Search
Facebook
Instagram
Friend / Family
Physician Referral
News Article
Other
Physician Referral
Please provide the physician's name.
Other
Please let us know how else you heard about us.
First Name
*
Last Name
*
Email
*
Phone
*
Date of Birth
*
Month
Day
Year
Address, City, State, Zip
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Message
*
How Can We Help you?
*
Please Choose
New Patient
Existing or Returning Patient
Message and instructions for international returning patient.
Services you are interested in
*
Donor Egg IVF + Surrogacy
Own Egg IVF + Surrogacy
Donor Egg IVF
Own Egg IVF
Egg Freezing
Reciprocal IVF
Sending your existing embryos to us
Other
Other Services
How did you hear about us?
*
Please Choose
Google / Web Search
Social Media
Friend / Family
Surrogacy or Donor Agency / Lawyer
Live Event
Webinar
Advocacy Organization
News Article
Other
Agency Name
Live Event
Other
First Name
*
Family Name
*
Email
*
Country
*
Country Code
Phone
*
City
*