Be an egg donor	Need an Appointment? We are glad you decided to make an appointment with us at RMA of Connecticut. Please fill out the form below so one of our patient coordinators can schedule your initial consultation. You can also schedule an appointment by calling 203-750-7400. First Name*: Middle Initial: Last Name*: Email*: Telephone*: Insurance Carrier: Day and Time: Select Day Monday Tuesday Wednesday Thursday Friday / Select Time Any Time Early Morning Late Morning Lunchtime Mid-Afternoon Late Afternoon Note: If you have a specific day of the week or time of day that works better for your schedule, please enter above. We will make every effort to fulfill your request. Physician: Select Physician Any Physician Dr. Mark P. Leondires Dr. Spencer S. Richlin Dr. Joshua M. Hurwitz Dr. Cynthia M. Murdock Note: If you do not desire a specific physician, then you must chose "Any Physician" in the physician group. Location: Select Location Norwalk Danbury Requests/Comments:

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Office Locations: Coming Soon:

(800) 865-5431 • E-mail: inquiries@rmact.com 10 Glover Avenue • Norwalk, Connecticut (CT) 06850 67 Sand Pit Road • Suite 300 • Danbury, Connecticut (CT) 06810 70 Maple Avenue • Rye, New York (NY) 10580 40 East Putnam Avenue, 1st Floor • Greenwich, Connecticut (CT)

Notice of Privacy Practices

This Notice of Privacy Practices (the “Notice”) is meant to inform you of the uses and disclosures of protected health information (“PHI”) that we may make. It also describes your rights to access and control of you protected health information and certain obligations we have regarding the use and disclosure of your PHI.

Your PHI is information about you created and received by us, including demographic information, that may reasonably identify you and that relates to your past, present or future physical or mental health or condition, or payment for the provision of your health care.

We are required by law to maintain the privacy of your PHI. We also are required by law to provide you with this Notice of our legal duties and privacy practices with respect to your PHI and to abide by the terms of the Notice that is currently in effect. However, we may change our Notice at any time. The new revised Notice will apply to all of your PHI maintained by us. You will not automatically receive a revised Notice. It will be posted on this website, or you may contact your Patient Coordinator, or ask at your next appointment.