Submit Your Own FSAC Testimonial

Testimonial submission is entirely voluntary. All testimonials will be reviewed for authentication prior to being posted online. Any patient who submits a testimonial can choose to have it removed from our website by requesting removal in writing to contact@fertilityassociates.com.

Did you have a great experience at FSAC? We’d love to hear about it!

Share Your Testimonial Here:

Upload A Photo (optional):

Please upload a .jpg or .png file. File size max is 2M.


Your Name (required)

Please type in your full name. This is only for our records and will not be displayed with your testimonial unless you have chosen to do so below.

How would you like your testimonial credited? (required)

Your Email (required)

Your email address will not be given out or posted with your testimonial. We will use it if we need to contact you regarding your testimonial.

Your Phone (required)

Your phone number will not be given out or posted with your testimonial. We will use it if we need to contact you regarding your testimonial.

Testimonial Authorization

I hereby grant Fertility & Surgical Associates of California, Inc. permission to use my written testimonial and likeness in any photograph, video or other digital or print reproduction (the “Materials”) in any and all of its publications, including websites, without payment or any other consideration. I understand and agree that the Materials will become the property of Fertility & Surgical Associates of California, Inc. and will not be returned. I hereby authorize Fertility & Surgical Associates of California, Inc. to edit, alter, copy, exhibit, publish or distribute the Materials for purposes of publicizing its programs or for any other lawful purpose.

I understand that the information disclosed, or some portion thereof, may be protected by state law and/or the federal Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). I further understand that, because Fertility & Surgical Associates of California, Inc. is not receiving the information in the capacity of a health care provider by HIPAA, the information described above may no longer be protected by HIPAA.

I understand that I have the right to inspect and copy the information that I have authorized to be disclosed. I further understand that I have the right to revoke this authorization in writing at any time, but if I do so it won’t have any effect on any actions taken prior to my revocation.

I certify that I have read the above Authorization and Release and fully understand its contents, meaning and impact of this release.

Yes, I Agree

Have More Questions?

Call us at 800-961-1801 or Contact Us Online to schedule a confidential consultation.

Office Hours

We have three convenient locations to better serve your needs. FSAC is open 365 days a year. Please contact our office for office hours and appointment availability at each location.

Emergencies

If you have an urgent need when we are not in the office, please call 805-778-1122 and the answering service will contact the physician on call. If you have a life threatening emergency, dial 911.

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