Patient Forms

I have decided to donate my baby's cord blood, what should I do next?

If you have not received one, please ask your participating OB Provider for a Cord Blood Donation Guide during your 28-36-week prenatal visit.  You can also request a Cord Blood Donation Guide here.

The Donation Guide contains all the forms needed to donate, along with frequently asked questions regarding cord blood donation.  Once you have decided to to donate, send the completed and signed forms to Upstate Cord Blood Bank using the postage-paid envelope included in the Donation Guide.  Our staff will review the forms for completeness and forward them to your delivering hospital.

If you are unable to mail your completed and signed forms prior to delivery, you may bring them with you to the hospital at the time of your delivery.

You may 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 provides a source of stem cells for those patients who are unable to find a bone marrow or adult donor match. It is free to donate and will not change your birth-plan in any way!

Make the decision to donate your cord blood.  Speak with your OB provider about the benefits of cord blood donation and contact the Upstate Cord Blood Bank at (315) 492-2600for more information about the process.

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.