CORD BLOOD DONATION
APPLICATION FOR CB DONATION
In the application form, the following are included: a medical history of you and your family, a signed consent with which you agree to proceed to the cord blood donation of your child in the public cord blood registry, and a signed consent of your obstetrician that he/she agrees to perform the collection.
With the completion of the application form you agree to the following:
- The cord blood of your child will be evaluated whether it meets the storage criteria; only then it will be stored in the registry.
- If the cord blood is not suitable for use in transplantation, it will be destroyed following standard practice. It will not be used for any research purposes without your written consent.
- Samples from you and the cord blood will be tested for diseases that may be transmitted to the patient or may aﬀect the transplantation process. All results will be kept conﬁdential.
- In case of any conﬁrmed positive test results that may aﬀect your child’s or your health will be provided to you with the corresponding professional counseling if necessary.
- The cord blood unit will be tissue typed and then listed in the registry.
- Six to twelve months post donation, you will be contacted and asked for any health related problems that may aﬀect the suitability of the stored cord blood.
- The cord blood will remain in the registry for 20 years or until it is no longer suitable for storage.
- The cord blood unit will be given to any patient in need of transplantation independently of his race, ethnicity or religion.
- There will be no ﬁnancial burden to you regarding the cord blood storage of your child.
- Upon completion of the storage procedure, the cord blood unit cannot be removed from the registry for any reason other than for transplant related purposes.
To donate your child’s CB you can complete the CB Donation Form and send it by fax at 22772888 or by email at firstname.lastname@example.org and call at the registry for conﬁrmation of its receipt. You can also request to be sent a copy of the form by fax or by email by calling at 22772700.