Precautionary Measures - Coronavirus - covid 19
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Home MAR - Contact form
If you would like more information about your particular case, you can fill in the contact form below.
Our MAR centre will answer you as soon as possible.
At which e-mail address can we reach you?
What is your gender?
Female
Male
How old are you?
Are you affiliated with a Belgian mutual insurance company?
Yes
No
Would you like to carry out a fertility treatment with your partner?
If so, with a man or a woman?
Man
Woman
How old is he/she?
Are you currently being treated on our Centre (Chirec)?
What language do you speak?
Would you like more information about sperm donation?
If yes, with an anonymous or known donor?
Anonymous donor
Known donor
Would you like more information about oocyte donation?
Would like more information about:
Oocyte freezing (Social freezing)
Sperm freezing
A co-parenting project
Surrogacy
Other
You can only choose 4 optionss.
Other: please specify
Send