Permission to collect umbilical cord blood

Unique Hospital ID Label

This page contains information about donating cord blood to the public cord blood bank managed by Canadian Blood Services (the “Cord Blood Bank”). Choosing to donate cord blood to the Cord Blood Bank is voluntary. Alternative options include storing cord blood at a private cord blood bank for your or your family’s potential future use, or not donating or storing the cord blood. If you decide not to donate cord blood to the Cord Blood Bank, this will not have any impact on you or your family’s medical care. If you donate cord blood to the Cord Blood Bank, the cord blood cannot be transferred to a private cord blood bank.

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F800380 Revision 1 (Legacy # 1000106728)