Vial Buy Back Request Form Please complete all the fields on this form. * ALL FIELDS ARE REQUIREDCustomer Name:(Required)Phone Number:(Required)Email Address:(Required) Order Number(s):(Required)Number of Vials Purchased:(Required)IUI:ICI:IUI ART:ICI ART:ICSI:Vials to Return:(Required)IUI:ICI:IUI ART:ICI ART:ICSI:Reason for Return:(Required)Achieved Pregnancy:(Required) Yes No Preferred Refund Method:(Required) PayPal PayPal Email Address(Required) All refunds are issued via PayPal. Seattle Sperm Bank reimburse the customer 50% of the original purchase price for any unused units that are stored at our lab in Seattle. Our buy back program is valid for 24 months after purchase, and does not apply to any shipping or storage fees, or to any discounts offered. All vials must have been purchased and stored at Seattle Sperm Bank without ever leaving the premises. Samples that have left our facility are no longer eligible for the buy back. Vial buy back is subject to approval by the Seattle Sperm Bank, and all storage accounts must be up to date in order to receive a refund. Discounts or promotions are not available for refunds. Any refunds will be made via PayPal. Terms and conditions are subject to change.CAPTCHA