IVF Fund Application

 

The Bob Woodruff Foundation (BWF) IVF Fund complements the efforts of multiple veteran-serving organizations that successfully advocated for legislation allowing the Department of Veteran Affairs to provide in-vitro fertilization (IVF) treatment to veterans who have lost the ability to conceive due to injuries incurred during service to our nation.

Since it will take time for the legislation to take effect, BWF will offer financial assistance to affected veterans to cover unreimbursed costs up to $5,000 associated with IVF treatments. The IVF Fund, supported by grants from Merck & Co., Ferring Pharmaceuticals, and EMD Serono, complements the “Serving Our Veterans” program established by the American Society for Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART). 

The origin of this initiative came out of the groundbreaking “Intimacy After Injury” conference, hosted by the Bob Woodruff Foundation in December 2014. This two-day event explored the effects of war injuries on sexual relationships and fertility.

For questions please email: ivf@bobwoodrufffoundation.org

 

*For an example of the content required in the letter from your SART clinic, please click here.

 

*For an example of the content required in the letter from your VA coordinator, please click here.

 

  • MM/DD/YYYY
  • MM/DD/YYYY (or Present)
  • Spouse/Partner Information

  • MM/DD/YYYY
  • MM/DD/YYYY (or Present)
  • Insurance

  • Provider

  • VA or DoD Lead Coordinator

  • Required Documents

  • VA disability determination letter or documentation from the VA stating that inability to conceive is the result of a service-related injury.
  • Confirmation from a VA or DoD lead coordinator that applicant has engaged an IVF provider and is requesting financial support from the Bob Woodruff Foundation.

    Download a sample coordinator letter here.
  • A letter on IVF provider letterhead stating the following: Provider is a SART member participating in the military appreciation discount program. Provider has a board certified reproductive endocrinologist on staff. Applicant and spouse/partner have commenced IVF treatment and have completed fertility evaluation testing. Applicant has not exceeded a total of six attempts to accomplish three completed IVF cycles.

    Download a sample SART letter here.
  • Consent and Authorization

    INTERNET CONSENT AND AUTHORIZATION FOR RELEASE OF INFORMATION: By submitting this form, I fully understand that my file and personal information, some of which may be protected from disclosure without my consent under the Family Education Rights and Privacy Law (FERPA), is being entered in an Internet Accessible Database. My personal information and/or files may be stored on a web server and may be transmitted over the Internet. By signing this form, I am authorizing the Bob Woodruff Foundation and potential service providers to transmit my personal information/file information for the purpose of helping me obtain appropriate services. I understand that all of the information gathered will be kept in strict confidence and used to facilitate services that I have voluntarily requested. I further acknowledge that I am solely responsible for the truth and accuracy of the information contained in my file, and the Bob Woodruff Foundation may choose to remove my personal information/file in whole or in part for any reason and at any time. By agreeing to this consent and authorization form, you authorize your information to be inputted into a digital referral system. In doing so, you will not hold liable any parties involved in the network, or the internet and website provider.