We value your feedback.

Your insights help us better understand what matters most to you and how we can support your goals for making a difference in reproductive medicine. This short survey will only take a few minutes and will help us continue to connect you with the opportunities and information that matter most.

Step 1 of 12 - Q1

Name

This field is for validation purposes and should be left unchanged.

1) Do you believe in the American Society for Reproductive Medicine's (ASRM) mission to advance the science and practice of reproductive medicine?

Yes

2) In what ways have you engaged with ASRM? Please select all that apply.

I donate to ASRM.

A friend or family member received care with ASRM-affiliated professionals.

I am a current or past member of ASRM.

I have attended ASRM's Scientific Congress.

I have volunteered at ASRM.

I have used ASRM’s clinical resources, guidelines, or research materials.

I follow ASRM on social media.

I have visited the ASRM website.

I have used ASRM's patient education materials.

Other

2a) Other - Please specify:

Please specify:

2b) How frequently do you engage with ASRM?

How frequently do you engage with ASRM?

Weekly

Monthly

Every few months

Yearly

Rarely or never

Other

2b-i) Other - Please specify:

Please specify:

3) We like to send members like you occasional emails with updates including videos, stories, and information about how we are making an impact on your behalf. Would you like to receive these updates from our development team? (You can opt out at any time).

Yes, I want to receive occasional emails with updates.

No, not at this time.

4) Which aspects of ASRM's work are most meaningful to you?

Please rank the following according to their importance to you, with First Priority being your highest priority.

You may only select one answer for each option.

First Priority	Second Priority	Third Priority	Fourth Priority

Equipping professionals with the knowledge and skills to transform patient care.

First Priority

Second Priority

Third Priority

Fourth Priority

Advancing reproductive science through bold and innovative research.

First Priority

Second Priority

Third Priority

Fourth Priority

Championing public policy that protects and promotes reproductive health and family-building rights.

First Priority

Second Priority

Third Priority

Fourth Priority

Expanding access to ethical, evidence-based fertility care for all who need it.

First Priority

Second Priority

Third Priority

Fourth Priority

5) Was there an influential person in your life who inspired your interest in reproductive medicine?

Yes

5a) If yes, please indicate their relationship to you.

If yes, please indicate their relationship to you.

Parent/grandparent

Spouse/partner/significant other

Child/children

Other family member

Friend

Doctor/fertility specialist

Teacher or professor

Coworker/colleague

Other

5a-i) Other - Please specify:

Please specify:

6) When thinking about future generations, how important is it to you that ASRM continues to advance the science and practice of reproductive medicine?

Of utmost importance

Very important

Somewhat important

Not very important

Not important at all

7) Supporters often recognize the need to help ASRM in our efforts to shape the future of fertility care. Would you consider furthering our work in any of the following ways?

I already have	I am likely	I am somewhat likely	I am not likely

Donating online with a credit card

I already have

I am likely

I am somewhat likely

I am not likely

Mailing a check

I already have

I am likely

I am somewhat likely

I am not likely

Talking with a charitable giving officer face-to-face or on the phone about making a substantial impact

I already have

I am likely

I am somewhat likely

I am not likely

Making a recurring contribution

I already have

I am likely

I am somewhat likely

I am not likely

Donating from a Donor-Advised Fund

I already have

I am likely

I am somewhat likely

I am not likely

Donating from a Family Foundation

I already have

I am likely

I am somewhat likely

I am not likely

Giving appreciated assets (such as personal or business stocks or bonds, land, or rental real estate, etc.)

I already have

I am likely

I am somewhat likely

I am not likely

Transferring a portion of my IRA account to ASRM (Qualified Charitable Distribution)

I already have

I am likely

I am somewhat likely

I am not likely

Making a charitable gift that provides a lifetime income to me or my loved ones

I already have

I am likely

I am somewhat likely

I am not likely

8) Many people like to include a gift to ASRM in their will or estate plan to protect and support progress in reproductive health and science. Would you consider including a gift to ASRM to benefit future generations of patients and professionals?

I have included a gift for ASRM in my will, trust, or by beneficiary designation.

I am interested in making this type of gift to ASRM.

Not now, but in the future I would definitely be interested in making this type of gift to ASRM.

Not now, but in the future I might possibly be interested in making this type of gift to ASRM.

I am not interested in this type of gift.

8a) Please tell us about your legacy gift:

Please tell us about your legacy gift:

I planned this gift in honor or in memory of someone.

I would like this gift to go to a specific purpose.

ASRM may use this gift where it will do the most good.

8a-i) Please provide the name of and/or association with this person:

Please provide the name of and/or association with this person:

8a-ii) Please describe the intended purpose:

Please describe the intended purpose:

Would you like us to provide additional information to help with your decision?

Smart Ways to Make an Impact Now

Tax-Wise Ways to Make an Impact

Simple Ways to Create Your Legacy

Making an Impact with Your Donor-Advised Fund

Help Advance Reproductive Health for Generations to Come

9) How does ASRM rank in comparison to other non-profits you may support?

My top choice for charitable giving

Near the top of my list

Middle of my list

Bottom of my list

Not on my list

9a) Do you have any friends, colleagues, or family members with similar interests who would consider supporting the mission and vision of ASRM?

Do you have any friends, colleagues, or family members with similar interests who would consider supporting the mission and vision of ASRM?

Yes

9a-i) Please let us know the most convenient way to connect:

Please let us know the most convenient way to connect:

I would like to introduce the person(s) to ASRM on my own.

I would like ASRM to provide me with resources to share with the person(s).

10) We would love to hear your story. If you would like, please share a meaningful experience with ASRM that made a difference in your work.

11) About You (optional)

Age

Under 40

40 - 49

50 - 59

60 - 69

70 - 79

80 - 89

90+

Gender

Male

Female

Other/Nonbinary

Prefer not to specify

Please specify:

What is your marital status?

Married

Not married

Divorced

Widowed

Which of the following best describes your family?

No children

One child

Two or more children

Please select the option(s) that best describes your professional life.

Working full time

Working part time

Retiring within 5 years

Retired

Volunteering

Business owner or entrepreneur

Self-employed

Unemployed

Disabled

Board member for a nonprofit

Where do you serve as a board member?

Please check the box below if you would like to update your contact information.

I would like to update my contact information.

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First name(Required)

Last name(Required)

Address

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City

State

ZIP

Country

Phone

Email(Required)

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