Thank you for joining new mothers to build the nationwide inventory of cord blood for people in need of a transplant. Your compassion can mean the gift of hope for someone in need of a transplant.

Before You Get Started

There are some eligibility criteria for cord blood donation to check before you take the next step.  Please be sure you meet the following requirements:

  • You must be less than 34th week gestation to begin the application process
  • You must be 18 years of age or older in order to donate your baby’s cord blood
  • We cannot accept cord blood donations from multiple births (Acceptable for Private Storage-ONLY)
  • If you and your physician have chosen to delay the clamping of the cord after your child’s birth (Acceptable for Private Storage-ONLY) 

Donation Forms

If you meet these basic criteria, the next step in donating cord blood is to complete the health questionnaire to ensure the safety and quality of the cord blood. These questions help identify any potential risk to a transplant recipient. Many of the questions are not a reason for deferral, but do require further information or clarification before acceptability is assigned.

Online Form

Complete the forms online.
When your done, just download, print, sign,and mail to Cord for Life®.

Download the Forms

Download the forms and complete them manually.
When your done you just print, sign, and mail to Cord for Life®.

Note about donor information: The donor information section of the form provides demographic data for yourself, the baby’s father and your physician. In addition, it contains a “Baby’s Ethnicity” section. This information is used to assist in the National Marrow Donor Program genetic matching and will not be used, in any manner, to prevent your unit from being placed on the registry. 

If you have any questions, please call our toll free number (800) 869-8608 to speak to a cord blood specialist.

IMPORTANT: If you consider yourself to be at risk as described in the donation information, please do not donate. The standards and regulations set forth for all blood banks prevent us from accepting or using any cord blood from an at risk donor.

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Our purpose is to provide the expectant mothers with information necessary to discover the lifesaving potential of umbilical cord blood.

Copyright Cord for Life 2019. All rights reserved.

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