Viacord Cord Blood Banking and Research
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Enrollment Forms

Once you register with ViaCord, you will receive enrollment forms prior to the baby's birth. You will find a copy of the enrollment forms in the cord blood collection kit or you can click here to download a copy.

Even if you've already enrolled over the phone, we ask that you fill out these important forms. These documents include a consent form for testing, a contract, and health history questionnaire. Please return all completed documents to ViaCord. It is crucial that these forms are completed and returned to ViaCord so that the cord blood unit can be properly processed, stored, evaluated for release, if necessary.

Please complete and return the enrollment forms as soon as they arrive. The easiest way to return your enrollment forms to us is by faxing them toll-free to 1-866-565-2243 so you can keep a copy for your records as well. If you are calling from outside the United States, please call 1-617-914-3900.

 

Our Address:  ViaCord
 245 First Street
 15th Floor
 Cambridge, MA 02142
Our Fax Number:

1-866-565-2243


You may continue to store the cord blood unit for as long as you choose. However, if at any time you prefer to have the cord blood unit destroyed or donated to research or transferred we must have your consent in writing.

 

 

 

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