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Registration Forms

If you would like to download the forms to register with M.A.Z.E. Cord Blood Laboratories, you can do so by clicking on each link below. Print out the forms and mail them to us at the address listed.

If you are in a rush, you can fax them back to us at 914.683.0974 and, upon receipt of the fax, we will mail out your cord blood collection kit.  Alternatively, you can scan and email the forms back to us at Registration@MAZEcordblood.com..

M.A.Z.E. Cord Blood Bank Welcome Letter (PDF 62Kb) - Outlines our procedures and walks you through the registration process.

M.A.Z.E. Cord Blood Bank Payment Options (PDF 51Kb) - This form describes two types of payment options; also listed is the exact price of our services.

M.A.Z.E. Cord Blood Bank Informed Consent Form (PDF 69Kb) - Outlines the legal responsibility of parents and the cord blood bank. This form must be filled out in its entirety in order to store your baby's blood.

M.A.Z.E. Cord Blood Bank Health History Form (PDF 79Kb) - Asks for background information on infectious disease, health history and travel of both mother and father.  This form must be filled out in its entirety in order to store your baby's blood.

M.A.Z.E. Cord Blood Bank Financial Agreement Form (PDF 85Kb) - This is the financial contract between the parents and the cord blood bank. This form must be filled out in its entirety in order to store your baby's blood.

M.A.Z.E. Cord Blood Bank Authorization For Disclosure Form (PDF 53Kb) - This form allows us to communicate with our processing laboratory regarding your specimen. This form must be filled out in its entirety in order to store your baby's blood.

Questions? Ask a cord blood expert