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Questionnaire – Application Single Motherhood

Do you wish to start fertility treatment as a single woman? If so, please complete this questionnaire in full.
You can return the completed and signed form to us by mail at info@brusselsivf.be.

Based on the information you provide, our team of psychologists will decide whether to invite you for an exploratory interview.
In case of a negative decision, we will inform you in writing.

If the questionnaire is fully completed or returned to us, we will not be able to process your application.

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