How to Order

Order Form

Please read our Statement of Consent

Payment Method: *

Cheque - I will mail a cheque for the initial payment made payable to Smart Cells International.

Bank Transfer - I will make a direct transfer for the initial payment to the Smart Cells International account at: Habib Bank AG Zurich account number 10182235, Sort code 60 91 94

Debit / Credit Card - Please contact the Smart Cells International Office for details. Care Line (UK): +44 (0)845 604 5523

Mother's Details

First Name: *

Middle Name:

Surname: *

Date of Birth: *

Home Phone: *

Mobile Phone: *

Email: *

Father's Details

First Name:

Middle Name:

Surname:

Date of Birth:

Home Phone:

Mobile Phone:

Email:

Postal Address

Street: *

Town / City: *

County / Region: *

Postal / Zip Code: *

Country: *

Birth Details

Expected due date: *

Hospital name: *

Consultant: *

Service options

A deposit of £195 is required for our standard Cord Blood Collection Service. Please select any additional options below:

Choose optional services:

Cord Tissue Collection - £100

Book a Phlebotomist - £100

Where did you hear about us?:

Questions or Comments?: