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SAVE the cord blood for your child please complete the
following forms: |
To
DONATE the cord blood please complete the following forms: |
| Registration |
Registration |
| Sample
and Test Release Record |
Sample
and Test Release Record |
| Client
Service Agreement |
Allogenic
Informed Consent Form |
| Autlogus-Sibling
UCB Informed Consent Form |
Note:
We are only accepting donations from certain hospitals.
Please call your hospital to find out if your hospital
is one of them. |
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The
following registration forms for the Ellie Katz Umbilical
Cord Blood Program can be downloaded by clicking on each one
below:
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Cord
Blood Accepted for Metropolitan Area Only
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Click
the Adobe sign to get Acrobat Reader
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| � |
| Mail
your completed forms to: |
| Community
Blood Services |
| Bergen
Community Regional Blood Center� |
| P.O.
Box 39� |
| Paramus,
NJ 07653-0039 |
| Attention:Umbilical
Cord Blood Program |
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