Thank you for your interest in joining the Fertiquity network!

 

Please fill out this form once per Tax ID so that we can assess whether there is an opportunity to contract based on our current markets and partnerships. This form should be completed one time per Tax ID Number.

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Fertiquity does not directly contract for all services in all markets, so you may be redirected to one of our vendor or system partners depending on your specialty and location. 

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Our Partnership team reviews requests to join on an ongoing basis.  We will be respond as soon as possible if there is an opportunity to partner. Please note, we may not be able to to proceed with contracting immediately or at all.

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If you have an inquiry related to an already submitted request to join, please contact info@fertiquity.com.

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Please note: This form is for requests to join Fertiquity's network directly. Please contact your administrator to join through a system partner or an Independent Physicians Association.