Just to be clear this is not legal advice, and you should definitely run any sort of contract/legal agreement by a lawyer just to be sure. It's also important to know your state's laws surrounding artificial insemination because each state varies and what is legal in Colorado may not be the same elsewhere. For example, in Colorado it is only considered a legal insemination when administered by a physician. We hope that this can be helpful to people who are going through the same process as us.
Donor
Agreement
This agreement is made this _______________day of
_____________________ 20___, by and between _____________, hereafter referred
to as "Recipient" and ____________, hereafter referred to as “Second
Parent,” and ____________, hereafter referred to as "Donor."
NOW, THEREFORE, in consideration of the promises of each other,
Donor, Recipient, and Second Parent agree as follows:
Each clause of this agreement is separate from the others and
should a court refuse to enforce one or more clauses of this agreement, the
others are still valid and in full force.
1. Donor agrees and
understands that the purpose of the insemination is to produce a child or
children.
2. Donor agrees to be
tested for sexually transmitted diseases, specifically HIV, Chlamydia,
Gonorrhea, Syphilis, and Hepatitis A, B, and C. A copy of the Donor's
examination and testing results shall be provided to Recipient prior to
insemination.
3. Donor understands
that he is providing his semen for artificial insemination and agrees in
advance to consent to the adoption of any child conceived through this process
by the Second Parent. Donor waives paternity rights, if any, to a child
conceived through artificial insemination of sperm donated pursuant to this
agreement. Donor agrees not to attempt to form a parent-child relationship with
Recipient's child. Each party acknowledges and agrees that the relinquishment
of all rights, as stated above, is final and irrevocable.
4. Recipient and Donor
agree that Recipient has relinquished any and all rights that she might
otherwise have to hold Donor legally and financially responsible for any child
or children who result from the artificial insemination procedure. Each party
agrees the Donor shall not be named as the father on the birth certificate of
any child or children born from the artificial insemination.
5. Each party
acknowledges and agrees that she or he signed this agreement voluntarily and
freely, of his or her own choice, without any duress of any kind whatsoever. It
is also acknowledged that each party understands the meaning and significance
of each provision of this agreement.
6. There are no
promises, understandings or agreements between the parties other than those
expressly stated in this agreement.
7. This agreement shall
be construed under and in accordance with the laws of the State of Colorado,
including Colorado Revised Statutes 19-4-106.
____________________________ ______________
Signature of Recipient, __________ Date
_______________________________________ ______________
Signature of Recipient’s Wife/Domestic Partner Date
and Second Parent, ______________
____________________________ ______________
Signature of Donor, ___________ Date
Signatures of each of the above are certified by the assisting
physician, Dr. ________ at ________________ clinic.
__________________________________________ _______________
Signature of Assisting Physician, ______________ Date
_______Physician shall send this completed form to:
Colorado Department of Health and Environment
Vital Records Section
4300 Cherry Creek Drive South
HSVRD-VR-A1
Denver, CO 80246-1530
(303) 692-2200
(303) 692-2200
_______Physician shall send copies of completed form to Donor and
Recipient.
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