Qualification questionnaire for the birth mom.

Take a few minutes to answer some questions to see if you qualify to either Store or Donate your baby's birthing tissue. Your information is 100% anonymous and secure.

How to Donate or Store
  • Step 1: Complete Questionnaire
  • Step 2: Choose to Donate or Store
  • Step 3: Fill out additional Health and Consent Form

or resume your applicationArrow right

Common Questions

Are my answers anonymous?

Your answers are completely anonymous. We are HIPAA compliant and use ID numbers to identify your birthing tissue if you choose to store.

Why do I need to qualify to Store or Donate?

A screening process is in place to determine if your birthing tissue can be used. Just like blood donations, your donation must be tested to ensure that it is healthy and safe to use for yourself and others.

Is my information safe and secure?

Yes, your information is protected with a highly secure database. We are 21 CRF 11 compliant and use encryption to ensure that your information is safe and secure.