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Become Our Warrior of the Week

At CNY we believe in the power of each and every one of your stories. By sharing your story, not only can you help others by making them feel as though they are not alone in this journey, you also are helping shape healthcare policy by making (in)fertility a more public issue. Plus, when you share your story which will be shared with our community on instagram and facebook, you will feel the full love and support of our fertile community!

  • Partner's First Name
  • You (and Your Partner) photo
    Max. file size: 500 MB.
  • Your Story *

    Please provide a detailed account of your story. Some good things to consider may be: when did you start/how long have you been trying to conceive? What treatments have you done already? How many treatment cycles have you completed? What treatment are you currently doing or what treatment is coming up soon? What give you hope?
  • Your experience at CNY *

    If you've already sought some treatment at CNY, please tell us about your experience with someone on our team (doctor, nurse, embryologist, receptionist, etc) that has helped brighten your experience at CNY
  • I am planning on or would be interested in participating in Facebook, Instagram, Youtube, and other live broadcasts in which I am interviewed by someone at CNY Fertility to share more of my story.
  • If you would like to be tagged in the social media posts of your story, please include your social media handles
  • Terms & Conditions


    I hereby authorize CNY Fertility to distribute and share information relating to my personal history, medical history, and any past, present, or future treatments that I willfully provide to CNY Fertility. Sharing my testimonial, story, history, and other willfully disclosed information may be shared on but not limited to the CNY Fertility website, social media pages, live broadcast on social media platforms, printed advertisements and promotions, and distributed to third-party publishers. I agree that I am voluntarily sharing information about my medical health and/or services from CNY Fertility or other medical providers, and I am receiving no financial remuneration from CNY Fertility for providing my testimonial and allowing them to use my protected health information for marketing purposes.

    Right to Revoke

    I understand that I have the right to revoke this authorization at any time by providing a written request to the Privacy Officer at CNY Fertility. I understand that if I choose to revoke this authorization, it will become effective on the day the written revocation is received by CNY Fertility. Any prior uses and disclosures of my testimonial with my protected health information will not be subject to the revocation of the authorization. I understand that CNY Fertility will make its best efforts to remove my testimonial and protected health information from the CNY Fertility's website, social media pages, and printed marketing material but understand that it will be impossible to remove printed marketing material from circulation.

    Components of my Testimonial

    I understand that the client testimonial for CNY Fertility will only include my name, location, photograph, and information provided to the organization in my testimonial. I understand that all other protected health information that CNY Fertility creates and maintains for purposes of my care will not be used in my testimonial or for marketing purposes without prior authorization per privacy regulations of the state and Health Insurance Portability and Accountability Act (HIPAA).

    I agree and acknowledge that I am the primary subject of the submitted story and that I am the sole owner of any and all copyrights to photographs and images that I submit to CNY Fertility.

    I agree and acknowledge that I have read and understood all of the elements of this authorization for use of my client testimonial.