Are you 18 years or older?
Are you having a single baby during this pregnancy (not twins, triplets, etc.)?
In the past five years, can you agree that you have not engaged in high-risk behaviors such as illegal drug use or sex in exchange for money or drugs?
If you can answer "yes" to the questions above, you may be eligible to donate your baby's umbilical cord blood.
If you have had any of the following within the past year: a tattoo, ear or skin piercing, non-sterile acupuncture, accidental needle stick, and/or a blood transfusion, please contact us at (808) 983-2265 or our toll free number at 1-855-583-3085, for further screening.
How Do I Become A Cord Blood Donor?
Review the prescreening questions listed above. If you answered "yes" to the above questions, you may choose one of the following options:
Call our office at 808-983-2265 or toll free at 1-855-583-3085 and request for a packet to be mailed to you.
Download our short screening and consent forms by clicking here.
You may download the forms above if you are delivering at the following hospitals:
Kapi'olani Medical Center for Women and Children
Queen's Medical Center
Tripler Army Medical Center
Castle Medical Center
Maui Memorial Medical Center
Please mail the originals to:
Hawai'i Cord Blood Bank
1319 Punahou Street
Honolulu, HI 96826
Or bring the originals with you to the hospital if you are close to your due date and cannot mail the paperwork to us in time.
If you have any questions regarding these forms, or we have not mailed you an approval or deferral letter, please call us at (808) 983-2265 or our toll free number at 1-855-583-3085.
When you check into the Labor & Delivery Unit at the hospital to have your baby, you may ask your nurse for an enrollment packet.
Download Full Screening and Donor Demographic Information Form
This full screening and donor demographic information forms are only used if your baby's unit is selected for storing and future transplantation.
This form is normally completed with you over the phone after delivery.
However, if you wish to fill it out beforehand please download it from the link above, attach it in addition to the short screening and consent forms, and mail it back to us.
Please note that after submission, we may still have to contact you if there are any questions that need clarification.
For more information about the Hawai'i Cord Blood Bank Program please call (808) 983-2265 (BANK) or our toll free number at 1-855-583-3085 or email firstname.lastname@example.org.