* IF YOUR DUE DATE IS WITHIN 1 WEEK PLEASE CALL US ON +44 (0)1752 753723, AS YOU WILL NOT BE ABLE TO SUBMIT YOUR PAYMENT ONLINE
Processing and Storage of Cord Blood Stem Cells Includes:
We can accept payment by cheque, bank transfer, debit card, credit card or electron.
£160 to be paid up front prior to allocation & dispatch of the collection kit.
If answered “no” please provide details of the Health Care Professional who will carry out the procurement on the day:
In order to store your sample safely, we need to ask you a few questions. These are required to be asked by the Human Tissue Authority who licence us. We appreciate that some of these questions may be very sensitive. Your answers will be treated in strictest confidence.
Please indicate with a tick (√) Yes/No to the following
If you answer yes to any of the following you must give further details at the bottom of the form.
In signing this form I acknowledge that I am over 17 and able to donate blood.
I certify that I have answered the above questions truthfully and to the best of my knowledge.
I certify that I have received, read and understood the educational material provided to me and had the opportunity to ask any questions.
You can contact us via email, fax,
telephone or letter. We look
forward to hearing from you.
CALL US ON: +44 (0) 1752 753723 FAX US ON: +44 (0) 1752 779777 EMAIL US AT: firstname.lastname@example.org
Plymouth International Medical & Technology Park
24 Brest Road
Plymouth, PL6 5XP
Biovault Family Umbilical Cord Blood Storage