You will be noticed about some possible mistakes in filling in the form. Filling in correctly and completely will give us the opportunity to proccess the data in an accurate and rapid way.
This registration does not involve any obligation.
After filling in and mailing the registration form, you will receive all the neccesary information regading the next steps to follow.
It is neccesary to fill in ALL the fields so as the registration can be validated.
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Information about the mother |
| Last Name : |
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| First Name : |
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Ocupation : |
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Mailing Address |
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City / Town : |
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Country : |
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_ITELEFON1 : |
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_ITELEFON2 : |
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Email : |
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Pregnancy : |
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Probably date of delivery : |
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Hospital : |
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The Gynaecologist's Name: |
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A cata recoltare cu Cord Blood Center : |
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You have decided to harvest the ombilical cord blood.
Which one of the following determines you to come to the final decision? |
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Internet
Magazines
TV
Radio
Posters and leaflets in hospitals or other locations
From the gynaecologist
name :
From other doctor
name :
From maternity
From family or friends
From our Call Center
other sources
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| Questions and Suggestions |
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Ce v-a determinat sa alegeti serviciile
Cord Blood Center?
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Recomandarea medicului ginecolog
Experienta
Cele 2 banci deschise in Romania
Tarife practicate
Siguranta
Metoda de procesare
Client-service
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| Sunteti interesata sa primiti informatii cu privire la activitatea grupului / noutati medicale.
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Da
Nu
Cu ce frecventa?
Lunar
Trimestrial
Semestrial
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| In ce sistem urmeaza sa nasteti:
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Maternitate de stat
Maternitate privata
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Va rugam sa indicati care din urmatoarele 2 enunturi vi se pare mai sugestiv pentru activitatea
Cord Blood Center:
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Sangele placentar salveaza vieti !
Cordonul rosu salveaza vieti !
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