Cord Blood Donor Pre-Screening



Donating your newborn’s umbilical cord blood to Cord For Life can give hope to patients with blood cancers.

To determine whether you meet the basic guidelines for becoming a cord blood donor, please answer the questions below.  Please note that not all those who meet the basic guidelines will be able to donate.  Further information will be required for eligibility.


  • About You

  • Date Format: MM slash DD slash YYYY
  • Tattoos and Piercings

  • Blood Diseases and Transfusions

  • Infectious Diseases

  • Sexually Transmitted Diseases

  • Malaria

  • Medications

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Our purpose is to provide the expectant mothers with information necessary to discover the lifesaving potential of umbilical cord blood.

Copyright Cord for Life 2019. All rights reserved.

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