believe the decision to exchange information between a child conceived by artificial insemination with donor sperm and the sperm donor should be mutual. At the time I am signing this statement my feeling about exchange of information is as follows.

I am willing to consider some exchange of information in the future between myself and children conceived by artificial insemination with my sperm through your donor sperm program. The terms of this exchange are:

1. The OHSU Andrology/Embryology Lab (the Lab) will never release any information about me which would allow me to be identified, as agreed upon in the consent I signed with the Lab.
2. The Lab has my permission to contact me by phone or in writing, or attempt to contact me by phone or in writing, in response to a request from an adult child who has achieved at least 21 years of age, conceived by artificial insemination with my sperm, who wishes to obtain more information about me.
3. If I agree at that time, the Lab may forward written correspondence to me from the adult child and I will consider the appropriate response. The Lab may act as intermediary in the exchange of information, both forwarding written correspondence to me, and forwarding my written correspondence to the child, if I desire.

4. It is my feeling at this time that I am willing to entertain an exchange of information, although I do not know exactly what information about myself I would be willing to provide. In particular, I do not know whether I would be willing to release my identity. Because this exchange is to be so far in the future, and I cannot know what my life situation will be at that time, I reserve the right to make all decisions on the information I would provide about myself.

To facilitate contact with me in the future, I will attempt to keep the Lab informed of my current address.

The Lab has my permission to inform recipients of the terms of this statement.