Known Donor Insemination Agreement Template
This Known Donor Insemination Agreement (“Agreement”) is entered into as of [Effective Date], by and among:
Recipient / Intended Parent: [Full Legal Name], of [Address]
Additional Intended Parent, if applicable: [Full Legal Name], of [Address]
Donor: [Full Legal Name], of [Address]
Together, the parties are referred to as the “Parties.”
1. Purpose of Agreement
The purpose of this Agreement is to set the terms under which Donor will provide sperm for use in assisted reproduction by Recipient, and to record the Parties’ expectations regarding conception, parentage intent, medical disclosures, expenses, privacy, and future contact.
The Parties state that they are entering into this Agreement voluntarily and before conception.
2. Method of Conception
The Parties intend that conception, if it occurs, will take place only through assisted reproduction and not through sexual intercourse.
The intended method is:
☐ Home insemination
☐ Intrauterine insemination (IUI)
☐ Intracervical insemination (ICI)
☐ Fertility clinic procedure
☐ Other method: [Describe]
Clinic or provider, if any:
[Name of Clinic / Provider / Practice]
3. Parentage Intent
The Parties state their intent regarding legal parentage as follows:
☐ Donor is intended to be only a donor and not a legal parent of any resulting child
☐ Donor is intended to have a parent role as follows: [Describe]
☐ Recipient is intended to be a legal parent
☐ Additional Intended Parent is intended to be a legal parent
☐ The Parties understand that further court, statutory, or administrative steps may be required under applicable law
Additional parentage terms:
[Describe intentions regarding legal parentage, custody, support, or future parentage filings]
4. No Sexual Relationship Requirement
The Parties agree that semen donation and conception efforts under this Agreement are intended to occur only by assisted reproduction methods.
No Party is required or expected to engage in sexual intercourse for purposes of conception under this Agreement.
Before donation, Donor shall disclose, to the best of Donor’s knowledge:
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relevant medical history;
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family medical history reasonably known to Donor;
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infectious disease information reasonably known to Donor;
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current medications, if relevant;
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prior donation history, if relevant; and
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any other material health information reasonably related to the donation.
relevant medical history;
family medical history reasonably known to Donor;
infectious disease information reasonably known to Donor;
current medications, if relevant;
prior donation history, if relevant; and
any other material health information reasonably related to the donation.
Screening, testing, or evaluation expected before insemination:
☐ STI / infectious disease testing
☐ Genetic carrier screening
☐ Semen analysis
☐ Clinic intake requirements
☐ Other: [Describe]
Responsibility for arranging and paying for screening shall be as follows:
[Describe]
6. Donation Process and Timing
Donor agrees to provide sperm donation as follows:
[Describe expected number of donations, timeframe, coordination process, and any clinic or storage procedures]
The Parties understand that no pregnancy or live birth is guaranteed.
If the Parties stop trying to conceive under this Agreement, they shall handle any stored samples as follows:
[Describe destruction, transfer, storage continuation, or other instruction]
7. Costs and Reimbursement
The Parties agree that the following expenses shall be handled as follows:
Medical screening costs: [Allocation]
Clinic or laboratory fees: [Allocation]
Storage or transport fees: [Allocation]
Legal fees: [Allocation]
Travel or lodging costs, if any: [Allocation]
Other agreed costs: [Describe]
Unless otherwise stated here, Donor is not being paid for parental rights and is being reimbursed only for agreed expenses:
[Describe any flat reimbursement or write “None”]
8. Confidentiality and Privacy
The Parties agree to keep private and not unnecessarily disclose non-public medical, personal, and reproductive information learned through this Agreement, except:
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as required by law;
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as needed for medical care;
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as needed for parentage, birth registration, or court filings;
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as needed for tax, insurance, or professional advice; or
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as otherwise agreed in writing.
as required by law;
as needed for medical care;
as needed for parentage, birth registration, or court filings;
as needed for tax, insurance, or professional advice; or
as otherwise agreed in writing.
Any special privacy expectations are as follows:
The Parties agree that records relating to donation, testing, insemination attempts, pregnancy, birth, and the child’s health may be shared as follows:
[Describe what may be shared, with whom, and when]
Recipient and any Additional Intended Parent may provide Donor with the following updates, if agreed:
☐ Pregnancy updates
☐ Birth information
☐ General child updates
☐ Medical updates relevant to hereditary conditions
☐ No updates unless later agreed
☐ Other arrangement: [Describe]
The Parties agree that future contact between Donor and any resulting child shall be handled as follows:
☐ No ongoing contact expected
☐ Limited contact by mutual agreement
☐ Identifying information may be shared at age [Age]
☐ Ongoing known donor relationship as follows: [Describe]
☐ Other arrangement: [Describe]
The Parties understand that future circumstances may change and that any later changes should be made in writing where possible.
11. Birth Registration and Future Legal Steps
If a child is conceived under this Agreement, the Parties intend to handle birth registration, parentage forms, or related legal steps as follows:
[Describe intended birth certificate expectations, declarations, court orders, or legal review process]
The Parties understand that applicable law may require additional filings, declarations, or court orders to confirm intended parentage or donor status.
12. No Child Support or Custody Intent
The Parties’ present intent regarding custody, support, and parental responsibility is as follows:
[Describe whether Donor is not intended to have custody or support obligations, or describe a different arrangement]
The Parties understand that enforceability of these terms may depend on applicable law and later court determinations.
13. Independent Review Opportunity
Each Party acknowledges that:
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the Party has had the opportunity to ask questions about this Agreement;
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the Party has had the opportunity to seek independent legal advice before signing; and
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the Party is signing voluntarily and without coercion.
the Party has had the opportunity to ask questions about this Agreement;
the Party has had the opportunity to seek independent legal advice before signing; and
the Party is signing voluntarily and without coercion.
14. Governing Law
This Agreement shall be governed by the laws of [State/Country], except to the extent mandatory parentage, reproductive law, family law, or public policy rules apply.
15. Entire Agreement
This Agreement contains the complete understanding among the Parties regarding the known donor insemination arrangement described above and supersedes prior oral or written discussions on that subject.
Any amendment to this Agreement must be in writing and signed by the Parties.
16. Signatures
Recipient / Intended Parent:
Signature: __________________________
Name: [Full Legal Name]
Date: [Date]
Additional Intended Parent, if applicable:
Donor:
17. Optional Witness or Notary
Witness / Notary, if desired:
Signature: __________________________
Name: [Name]
Title: [Witness / Notary / Other]
Date: [Date]
