Test Page - AlphaCord - Newborn Stem Cell Banking

Order Summary

TODAY’S TOTAL

$0.00

STEP 1: YOUR INFORMATION

(optional)

STEP 2: SHIPPING

Where should we ship your
collection kit(s)?

Same address as contact

Enter new address

Please Select How Your Collection Kit(s) Will Be Sent From AlphaCord To You:

Hospital Address

Please Select How Your Collection Kit(s) Will Be Sent From Your Hospital
To Our Lab:

Priority Overnight – FREE

Specialized Medical Courier - $250

STEP 3: PAYMENT

Billing Address

Same address as contact

Enter new address

First name *

Last name *

Country / Region *

Phone *

Email address *

Street address *

Town / City *

State / County *

Postcode / ZIP *

Credit Card

Product Quantity	Total
Cart Subtotal	$0.00
Order Total	$0.00

Credit Card (Stripe)
- Use a new payment method
Card Number *

Expiry Date *

Card Code (CVC) *

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PayPal

Pay via PayPal.

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What happens next?

After you complete your order, we will send a packet with everything you need to know. Welcome to the AlphaCord family!

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