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To be eligible for the grant, please send under separate cover a letter from your physician documenting medical indication for in vitro fertilization treatment. The letter must also include treatment protocol for individual diagnosis.

These letters should be sent to:

Lotus Blossom Consulting, LLC
180 N. LaSalle Street
Suite 1925
Chicago, IL 60601

Or scanned and emailed to: consultant@lotusblossomconsulting.com

Or faxed to: 847-881-2585

Jude Andrew Adams Charitable Fund Application
  1. (required)
  5. (required)
  6. (valid email required)
  7. (required)
  8. (required)
  9. (required)
  13. If you do not have a physician, would you like a referral?
  15. Have you undergone treatment in the past?
  18. Do you have any embryos frozen?
  20. Was any of past treatment covered by insurance benefits?
  22. Do you have insurance benefits for present or future infertility treatment?
  24. Do you have insurance benefits for medications?
  26. Have you ever been pregnant?
  32. Would you be interested is learning about opportunities for discounted treatment and medication options and or trial studies that may be available nationwide?
 

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