You need to have both Malka Ella Rabbis and your own Rabbi sign off the application forms. The Malka Ella Rabbis, Rabbi Gidon Fox and Rabbi Yechezkiel Auerbach, have vast experience and knowledge in the field of fertility and thus either one of them need to sign off the forms B1-B4. As your own Rabbi knows your specific case, the forms also need to be signed off by him.