babycells Kit Order Form

REQUEST BROCHURE

How much does it cost?

Frequently Asked Questions (FAQs)

babycells ORDER FORM

UK CUSTOMER ONLY - PAYMENT VIA CHEQUE OR BANK TRANSFER

Mother's Details

First Name:

Last Name:

Address:

Post Code:

Country:

UNITED KINGDOM

Telephone:

Mobile:

Email:

Father's Details

First Name:

Last Name:

Telephone:

Mobile:

Email:

Other Details

Expected Date of Birth:

Birth Details:

Single Birth Twins Triplets

Hospital:

Consultant's Full Name:

Midwife's Full Name:

Source of Advertisement:

Additional Information:

Payment Method:

Bank Transfer Cheque

Payment Details:

Bank Transfer:

If using bank transfer, please send the payment to the following account:

Account Name:	Cells Limited
Account Number:	50082317
Sort Code:	20-37-16
Bank:	Barclays Bank PLC
Branch:	Station Road, Harrow, HA1 2AE

Cheque Payment:

If paying by cheque, please make the cheque payable to Cells Limited and send it to the following address:

Cells Limited

Temple House

221-225 Station Road

Harrow

HA1 2TH

United Kingdom

I understand that the £125 including VAT (£250 for twins and £375 for triplets) paid for the collection kit(s) is non-refundable and that if the sample is not successfully stored I shall not be responsible for any further payments.

I Agree