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Register for the Public Cord Blood Bank

Register for the Public Cord Blood Bank

Volunteer form
*Required field

Baby’s mother



*

Address

Québec

ext.

If yes, please fill out our change of address form by clicking here.

*Baby’s father



*

*Information about the pregnancy

Consent for registration in the Public Mothers’ Milk Bank

*CONSENT TO REGISTRATION IN THE PUBLIC CORD BLOOD BANK

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