Registration

Enrollment Form

* Compulsory fields

Mother’s Data Surname: *
First Name: *
Title:

Permanent Address Street Name and Number: *
City: *
Post Code: *
Country: *

Correspondence Address* (if it´s different than permanent address) Street Name and Number:
City:
Post Code:
Country:

Telephone: *
E-mail: *

Have you used services of Cord Blood Center Group before?YesNo
Pregnancy: *
Delivery Due Date: *
Chosen maternity hospital Hospital Name: *
Hospital Addres: *
Street Name and Number: *
City: *
Post Code: *
Country: *
Father’s Information Surname:
Fist Name:
Title:
Telephone:
Other

Your comments and questions (only accepted in English, German, Hungarian or Slovak language)

Fill in the language for document sent to you *

Personal Data Protection

CORD BLOOD CENTER s.r.o., Kosicka 10, Bratislava (hereafter “CBC”) values the trust of its clients. CBC is aware of the sensitivity of any private information accessed or provided by third parties. Consequently and with all due respect to the appropriate legal demands CBC applies the following privacy protection measures.

Any private information provided by any person is treated as confidential. The only exception is carrying out obligations imposed on CBC by law (i.e. mandatory procedures for preventing the spread of infectious and transmittable diseases, the obligation to the obligation to cooperate with competent public authority etc).
Obtained non-public, personal or other information is used exclusively in the scope and purpose necessary to carry out the relationship with the entity in question (e.g. processing and storage of stem cells from umbilical cord blood). The information obtained is processed primarily by the CBC and only when needed is this information processed by cooperating entities, while respecting the privacy of the persons concerned.
Provided or made available public and private information are not provided without legal obligation (see point 1) for payment or free of charge to anyone other than the cooperating entity under the previous point.
CBC notes that if any person voluntarily provides any personal information at the same time it gives CBC within the meaning of § 4. 1 point. i) Law no. 428/2002 Z.z. Privacy Policy consent to the processing of all personal information (personal information of the person, the child and possibly father of the child), in particular the names, surnames, addresses, information about pregnancy etc. Consent is granted mainly to the inclusion of the personal information in the CBC databases and their use when communicating with the person, the collection of placental blood, its processing and storage and related operations. CBC has the status of the operator under the relevant provisions of the Privacy Policy. Consent to the processing of personal data is given voluntarily for an indefinite period and you can withdraw it in writing, by a registered letter of appeal. The operator is entitled to process personal data, until the granted approval is revoked under the preceding sentence. CBC is entitled to provide the processed personal information to a third party solely in connection with their processing. Under the same conditions and scope of the person granting consent to the processing of other information provided, devoid of the nature of personal data (eg telephone numbers, e-mail address etc).
If the person concerned grants any further consent to the processing of personal data and other treatment of the confidential facts (e.g. by signing informed consent or concludes the appropriate contract with CBC) it is considered that from that moment on, the rights and obligations of CBC are governed by the wording and scope of said contract.

If it not required by special law, CBC does not seek or process personal or other private information concerning any person of its own initiative. If, despite this any personal or other private information relating to any person is accidentally acquired, CBC does not process this information and keeps operating as if it was never acquired.