Refer a Sperm Donor for Evaluation

This form is for agencies submitting a sperm donor for psychological evaluation. It includes background information for the clinical interview and assessment.

Please complete all required fields. If you prefer to send details by email, you’re also welcome to reach out at rachel@rgoldbergtherapy.com.

If you're an individual sperm donor looking for services, please do not use this form. You can email me directly.

Logo of the American Society for Reproductive Medicine with red and gray design and text
Logo for SEEDS with a green leaf and the text "SEEDS" and "growing ethics" underneath.
Logo of the Mental Health Professional Group (MHPG), a professional group of the American Society for Reproductive Medicine.
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Dedicated support for surrogacy and egg donation agencies. We provide psychological evaluations and consultations for gestational carriers, egg and sperm donors, and intended parents—serving Alabama, Arkansas, Arizona, California, Colorado, Connecticut, District of Columbia, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Kansas, Kentucky, Maryland, Maine, Michigan, Minnesota, Missouri, Mississippi, North Carolina, North Dakota, Nebraska, New Hampshire, New Jersey, Nevada, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Vermont, Washington, Wisconsin, West Virginia, Wyoming.

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