Objective: Our goal was to investigate policy on patient access to services at assisted reproductive technology clinics in the United States. Study Design: Surveys asked about a variety of ethically and socially challenging cases and were mailed to directors of all Society for Assisted Reproductive Technology–associated assisted reproductive technology clinics. Results: Written policies on access to services are present at 40% of assisted reproductive technology clinics. Universal agreement was not found on any issue; 79% of clinics treat single women, 27% treat patients with a history of schizophrenia, 10% treat patients who use alcohol excessively, 7% treat human immunodeficiency virus–positive women, and 2% would treat patients previously convicted of child abuse. A breakdown of the responses indicated that some clinics are more permissive in terms of access to services than others, whereas some are more restrictive. Conclusions: The data demonstrate considerable variability in policy among clinics on most access-to-services questions. The results highlight the importance of ongoing discussion of the ethical and legal issues related to access and the need to develop consistent methods to deal with complex cases. (Am J Obstet Gynecol 2001;184:591-7.)