Share Your Story Let’s get started "*" indicates required fields Your Name*(Only first name and first initial of last name will be published) First Last Email* Did you have the ReceptivaDx (BCL6) test performed?* Yes No May we send you a separate email asking for information on how BCL6 made a difference in your fertility journey?* Yes No Tell Us Your StoryNurse's Name* First Last Email of nurse if available Physician's Last Name*Name, City, and State of IVF Center* Name of IFV Center City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Phone number of center, if availableTell us your story*800 word maximum.CommentsThis field is for validation purposes and should be left unchanged.
