Cord blood donation - Request for information

Have you read the brochure and do you want to donate umbilical cord blood? Then request the registration form from Sanquin by filling in the form below.

Please note: Due to limited resources (such as the training of midwives and gynecologists), it is only possible to donate cord blood in a hospital or birthing center that collaborates with the Cord Blood Bank of Sanquin.

Due date

Please fill in your estimated due date here.

In which hospital will you be giving birth?

It is only possible to donate cord blood in a hospital or birthing center that collaborates with the Cord Blood Bank of Sanquin.

Your midwife or gynecologist

Fill in the name of the midwife or gynecologist who is overseeing your care here.

Your initials

Your last name

Your email address