This Website uses cookies in order to offer you the most relevant experience. Please accept cookies for optimal performance.

Investor Relations Download Info Pack

Singapore

Web Enrolment

Invalid Input
Invalid Input
Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Biological Mother Details


Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Biological Father Details

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Emergency Contact Details


Invalid Input

Invalid Input

Refer-A-Friend's Details


Invalid Input

Invalid Input

Grandparents' Details


Cord Blood Network
Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Health History Questionnaire



All information herein will be kept strictly confidential, save for declaration required by law and/or for transplant purposes. We request your kind understanding that sensitive questions are asked to help us make the cord blood collection process and subsequent use safe.


All "Yes" answers require an explanation. Please use the space allocated at the end of this questionnaire.

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

12. In the past 5 years, have you had sexual contact

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Travel History
Invalid Input

Invalid Input

Invalid Input

Invalid Input

Genetic/ Family History
17. Has your baby’s biological father, his family members or any of your family members (biological parents and siblings) had:
Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

*The informed consent below applies to all Cordlife’s banking services you have enrolled for this pregnancy. The maternal blood test results and Medical Director’s decision may be required to determine eligibility of storage.

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

I understand that appropriate confidentiality will be maintained for all patient records concerning the Service, but that the Singapore Ministry of Health, or other government agencies may inspect records in accordance with applicable laws or regulations. I therefore certify that I have answered the above questions truthfully and to the best of my knowledge.
* Invalid Input

Invalid Input

[Important Announcement]

In this turbulent time, Cordlife is still operating in the education of umbilical cord banking and safeguarding this precious resource for families.

With the recent measures in place to curb the spread of COVID-19 by the Government, our consultation booths located at Mount Elizabeth Novena Hospital, Parkway East Hospital and Thomson Diagnostic Ultrasound Centre will be closed.

We apologise for any delays that you may be experiencing in reaching out to us at our 24-hour enquiry hotline at (65) 6238 0808 or emails.

However, our sales consultants will remain available through web consultations should you have any questions about our services/and or are interested to store your baby’s umbilical cord stem cells with us.

To find out more about cord blood banking, you may choose to download our information pack or make an appointment with our friendly consultants.

QUICK LINKS
WHY CORDLIFE
CORDLIFE CLIENTS

Address

1 Yishun Industrial Street 1,
#06-01/09 A'Posh Bizhub
Singapore 768160
Mondays to Fridays, 9.00am to 6.00pm

Privacy Policy

Contact Information

Customer Service Hotline: (65) 6238 0808
Email Us: info@cordlife.com
Fax: (65) 6238 1108

X            

Want to discover the power of umbilical cord stem cells?

Call us at 6238 0808 or make an appointment for a non-obligatory consultation!
Make an appointment
Listed on the Mainboard of Singapore Exchange and incorporated in May 2001, Cordlife Group Limited is a consumer healthcare company catering to the mother and child segment and a leading cord blood and umbilical cord lining banking services provider.
Copyright © Cordlife. All rights reserved.