Patient Forms

We have decided to donate our babies cord blood, what should I do next?

Please ask your participating OB Provider for a Cord Blood Donation Guide at your 36 week pre-natal visit.  The Donation Guide contains all required forms to donate, along with frequently asked questions regarding cord blood donation.  We ask that you send the forms via the pre-addressed and stamped envelope provided inside for your convenience. Please note you should not fill out the questionnaire or sign the consent prior to 30 days of expected delivery.
You can also print and fill out the following forms to be faxed to our office at (315) 492-2681.

Please note: It may take a few moments to load the forms if you are using a slow internet connection. If you are unable to view the pdf file, you may need to download Adobe Acrobat for free by clicking on the icon below.
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The use of cord blood is in high demand due to the great potential that stem cells have for treating many life-threatening diseases. Choosing to donate your cord blood with Upstate Cord Blood Bank will have such a significant impact and will not change your birth-plan in any way!

Be a hero, and make the decision to bank your baby’s cord blood for public use. Before your 36th week of pregnancy, please speak with your doctor about donating. For more information, please contact the Upstate Cord Blood Bank at (315) 492-2600.

Ready to donate your cord blood or have questions? Please contact Upstate Cord Blood Bank for more information on how to get started at (315) 492-2600.