Service Agreement - Test


This CELLSAVE Stem Cell Storage Agreement is a Contract that has been developed between “ CELLSAVE ” and the “Client” which sets out the General Terms and Conditions by which CELLSAVE and the Client will cover all aspects of the Parties agreement.

This is a very important document, which the Client should read through carefully.

The Client has to complete the Contract as described below and return it to us. A copy will be emailed to the Client for their own reference/record.

This document consists of the following sections:

     A. SERVICE AGREEMENT
     B. INFORMED CONSENT
     C. FEE SCHEDULE    

SERVICE AGREEMENT

  • As per Association for the Advancement of Blood & Biotherapies (AABB) and International Standards, this form should be signed before the birth of your baby.
  • Complete all parts of this form. This includes your full details, clinic/hospital, physician/ midwife, delivery due date, details for multiple births (if applicable), and loyalty reduction for returning Clients (if applicable).
  • It is important that we have the Clients’ full names as per the passport.

INFORMED CONSENT

  • As per AABB and International Standards, this form should be signed before the birth of your baby.
  • Complete all parts of this form.
  • This form gives us the consent for Cord Blood, Cord Tissue, Placental Tissue, Amnion Placental Tissue, and Cord Vessel collection.
  • It is important that we have the Clients’ full names as per the passport.

FEE SCHEDULE

  • This form provides the summary of fees payable, and will be in a separate page from this document.

A. SERVICE AGREEMENT

For the processing, testing, cryopreservation, and storage of Cord Blood Stem Cells and/or (if applicable) Cord Tissue/Placental Tissue/Amnion Placental Tissue/ Cord Vessel, between

CELLSAVE ARABIA FZ- LLC, a company with limited liability registered under the Dubai Healthcare City Authority (DHCCA), Organised and existing and operating under the laws of the United Arab Emirates;

Having its registered office at P.O. Box 505152, Dubai, United Arab Emirates;

Tel. +97143604410, E-mail Address: infoarabia@cellsave.com (Hereinafter referred to as “CELLSAVE ”).

And

The Parent(s)/Legal Guardian(s) listed below on their behalf and the behalf of the (unborn) Child

(Hereinafter jointly to be referred to as the “Client” or the “Clients”) ( CELLSAVE and the Client, together, the “Parties”)

(Client to fill in the relevant fields below)

MOTHER/LEGAL GUARDIAN

Last Maiden Name :

First Name:

Address:

Country :

City :

Postal Code:

Date of Birth :    

Telephone :

Mobile :

Email Address :

FATHER/LEGAL GUARDIAN

Last  Name :

First Name :

Address :  

Country :

City:                                         

Postal Code:

Date of Birth:    

Telephone :

Mobile:

Email Address:

CLINIC/HOSPITAL

Name :

Country:

City:

PHYSICIAN

Last Name :

First Name:

Country:

City:

Due Date for Delivery :    

Multiple Births Expected

    If Yes, how many?   

I (We) have previously-stored cord blood with CELLSAVE.

Reference of the Previous Child:

Service choice:

I (We), the undersigned Parent(s)/ and/or Legal Guardian(s) hereby confirm the following specific service from CELLSAVE:

Add a 5 chamber Storage Bag option - You will be charged extra 1,000 AED? 

KIT ID:  

 

GENERAL TERMS AND CONDITIONS

1. PURPOSE:

The purpose of this document is to set out the terms, conditions, limitation, risks, and costs of the processing, testing, cryopreservation, and storage in an authorized cellular processing and storage unit release of the Product (as defined below) obtained from the Specimen (as defined below) collected at the time of birth of the Child (as defined below) of the Client.

In this Service Agreement, the following definitions shall have the following meaning:

“Amnion Placental Tissue”   - the thin and elastic membrane lining inside of the placental sac.

“Child” - “Any child identified by the Client in the Informed Consent in Section B;

"Blood Cord” - Blood collected from the umbilical cord and placenta of the Child following delivery;

“Cord Tissue” - Tissue taken from the umbilical cord of the Child following delivery;

“Cord Vessel” - Cell types that lines the Cord Tissue taken from the Child following delivery;

“Enrollment Fee” - The meaning ascribed to it in the Fee Schedule in Section C;

“Extended Storage Period” - The meaning ascribed to it in Section 6; 

“Fees” - The meaning ascribed to it in Section 4;

“Informed Consent” - The consent attached to this Service Agreement under which the Client gives their informed consent to the storage of the specimen;

“Initial Storage Period” - The meaning ascribed to it in Section 6;

“Maternal Blood Test” - Tests which must be undertaken on the blood of the mother of the child (as identified and approved in the Informed Consent in Section B) to assess whether the Specimen is suitable for storage in accordance with international and local guidelines and regulations and as otherwise required thereunder;

“Medical and Health History Profile” - The questionnaire completed by the Client under which the Client provides CELLSAVE with certain information about his/her/their medical history. Refer to separate Medical and Health History Profile booklet;

“Processing Fee” - The meaning ascribed to it in the Fee Schedule in Section C; 

“Placental Tissue” - Organ that connects the developing fetus to the uterine wall; 

“Storage Fee” - The meaning ascribed to it in the Fee Schedule in Section C;

“Product” - The cryopreserved Stem Cells and the cryopreserved Cord Tissue (and, in the event that the CryoAdvanced Service is elected, the cryopreserved Stem Cells, the cryopreserved Cord Tissue, and the cryopreserved Placental Tissue), (and, in the event that the CryoUltimate Service is elected, the cryopreserved Stem Cells, the cryopreserved Cord Tissue, the cryopreserved Placental Tissue, the cryopreserved Amnion Tissue, and the cryopreserved Cord Vessel);

“Release Form” - The meaning ascribed to it in Section 8;

“Service Agreement" - This Service Agreement between the Client and CELLSAVE which shall include the Service Agreement in Section A, the general terms and conditions, the informed consent in Section B, the Medical Health History Profile booklet, and the fee schedule in section C;

“Specimen” - The Cord Blood and Cord Tissue (and in the event that the CryoAdvanced Service is elected, the Cord Blood, Cord Tissue, and Placental Tissue), (and in the event that the CryoUltimate Service is elected, the Cord Blood, Cord Tissue, Placental Tissue, Amnion Placental Tissue, and Cord Vessel);

“Stem Cells” - The Stem Cells extracted from the Cord Blood;

“Unit” - The meaning ascribed to it above.

“Product” - The cryopreserved Stem Cells and the cryopreserved Cord Tissue (and, in the event that the CryoAdvanced Service is elected, the cryopreserved Stem Cells, the cryopreserved Cord Tissue, and the cryopreserved Placental Tissue), (and, in the event that the CryoUltimate Service is elected, the cryopreserved Stem Cells, the cryopreserved Cord Tissue, the cryopreserved Placental Tissue, the cryopreserved Amnion Tissue, and the cryopreserved Cord Vessel), (and, in the event that the CryoInfinite Service is elected, the cryopreserved Stem Cells, the cryopreserved Cord Tissue as ready-to-be-used MSCs, the cryopreserved Placental Tissue, the cryopreserved Amnion Tissue, and the cryopreserved Cord Vessel as ready-to-be-used MSCs);

“Specimen” - The Cord Blood and Cord Tissue (and in the event that the CryoAdvanced Service is elected, the Cord Blood, Cord Tissue, and Placental Tissue), (and in the event that the CryoUltimate Service is elected, the Cord Blood, Cord Tissue, Placental Tissue, Amnion Placental Tissue, and Cord Vessel), ), (and, in the event that the CryoInfinite Service is elected, the cryopreserved Stem Cells, the cryopreserved Cord Tissue as ready-to-be-used MSCs, the cryopreserved Placental Tissue, the cryopreserved Amnion Tissue, and the cryopreserved Cord Vessel as ready-to-be-used MSCs);

“Product” - The cryopreserved Stem Cells and the cryopreserved Cord Tissue (and, in the event that the CryoAdvanced Service is elected, the cryopreserved Stem Cells, the cryopreserved Cord Tissue, and the cryopreserved Placental Tissue), (and, in the event that the CryoUltimate Service is elected, the cryopreserved Stem Cells, the cryopreserved Cord Tissue, the cryopreserved Placental Tissue, the cryopreserved Amnion Tissue, and the cryopreserved Cord Vessel), (and, in the event that the CryoInfinite Service is elected, the cryopreserved Stem Cells, the cryopreserved Cord Tissue as ready-to-be-used MSCs, the cryopreserved Placental Tissue, the cryopreserved Amnion Tissue, and the cryopreserved Cord Vessel as ready-to-be-used MSCs);

“Specimen” - The Cord Blood and Cord Tissue (and in the event that the CryoAdvanced Service is elected, the Cord Blood, Cord Tissue, and Placental Tissue), (and in the event that the CryoUltimate Service is elected, the Cord Blood, Cord Tissue, Placental Tissue, Amnion Placental Tissue, and Cord Vessel), (and, in the event that the CryoInfinite Service is elected, the cryopreserved Stem Cells, the cryopreserved Cord Tissue as ready-to-be-used MSCs, the cryopreserved Placental Tissue, the cryopreserved Amnion Tissue, and the cryopreserved Cord Vessel as ready-to-be-used MSCs);

 

 

By signing this Service Agreement, the Client agrees to be legally bound to CELLSAVE for the processing, testing, cryopreservation, and storage of the Specimen in any Unit. The Client also acknowledges that he/ she/they has/have been fully informed, and accept( s) and agree(s) to the conditions, risks, limitations, and associated costs of such activities, in accordance with these terms and conditions.

2. SERVICES OF CELLSAVE:

CELLSAVE’s obligations and liabilities are expressly limited to the services described in this Service Agreement; no other services will be provided by CELLSAVE to the Client and CELLSAVE expressly disclaims any responsibility to provide any other services other than the ones stated in this Service  Agreement.

CELLSAVE will not put the Specimen to use for any purpose other than to enable CELLSAVE to provide the Service to the Client as per this Service Agreement.

If the Client elects to use the CELLSAVE services the following provisions shall apply:

On receipt of the Specimen, CELLSAVE will use best endeavors to process and cryopreserve Stem Cells from the Specimen for the purpose of direct application in humans, provided a sufficient number of viable Stem Cells as per its acceptance criteria can be identified, CELLSAVE will store the Product for the Initial Storage Period (as defined in Section 6 below) or longer as agreed in accordance with Section 6.

In the event, after processing has commenced, there are insufficient Stem Cells in the Product or CELLSAVE is unable to harvest collected Stem Cells from the Specimen or if CELLSAVE determines that storage for other reasons is not possible (e.g. the Specimen is damaged or contaminated), no storage will take place and refunds will be as stipulated in Section C of the Fee schedule.

In the event where processing has not taken place due to reasons such as Specimen is received by CELLSAVE more than 72 hours after the birth of the Child, or the collected Specimen volume is too small, refunds will be as stipulated in section C of the Fee schedule.

With respect to Cord Tissue, on receipt of the Specimen, CELLSAVE will use its best endeavors to prepare it for cryopreservation and storage. In the event that the Cord Tissue has not been collected following the instructions, or if CELLSAVE determines that storage is for other reasons not possible (e.g. the Specimen is received by CELLSAVE more than 72 hours after the birth of the Child; the Specimen is damaged or contaminated), refunds will be as stipulated in section C of the Fee schedule.

If the sample/unit is being used for a transplant within 5 years (from the date of delivery of the baby), CELLSAVE will give the Client a “transplant assistance” valued at 15,000 AED.

3. RESPONSIBILITIES OF CLIENT:

The Client agrees to complete all necessary forms accurately and in a timely manner as CELLSAVE may from time to time reasonably consider as required or deemed beneficial to the Service in view of applicable legislation or industry standards.

The Client is responsible for arranging the collection of the Specimen by the physician, obstetrician, or other medical staff at the birth of the Child as per the instructions received from CELLSAVE. It is the responsibility of the Client to either contact CELLSAVE or the courier company designated by CELLSAVE after the Specimen has been collected.

CELLSAVE will arrange for transport of the Specimen to the CELLSAVE designated Unit, on the Client’s behalf, immediately after having received notification by the Client of the collection of the Specimen by the physician, obstetrician, or other medical staff at the birth of the Child. CELLSAVE expressly excludes all liability for the collection of the Specimen by the physician, obstetrician, or other medical staff at the birth of the Child.

CELLSAVE expressly excludes all liability for the transportation of the Specimen if done by a third party.

The Client agrees to act at all times in accordance with all applicable local legislation and regulations and will be responsible for obtaining all necessary documents and permits if so required for the collection and export of the Specimen to the Unit.

4. FEES AND PAYMENTS:

The fee for the Service (the “Fee”) and the payment conditions applicable to the Service are laid down in the Fee Schedule in Section C. The Fee consists of a non-refundable Enrollment Fee and a Processing and Storage Fee and certain other fees, in each case as further described in the Fee Schedule in Section C. Client agrees to pay the Fees on time and in accordance with the Fee Schedule in Section C.

Clients understand and agree that they are jointly and severally liable for payment of the Fees, which means that all of the Clients are liable to pay the Fees, and each Client is jointly and severally liable for any unpaid portion of the total fee. This applies even if Clients who are married or live together become divorced, separated, or otherwise estranged. 

5. STORAGE:

The Specimen and Product will be processed, tested, cryopreserved, and stored in accordance with the following terms:

a. CELLSAVE stores the Product in an authorized Unit. The Cord Blood Product will be split and stored in two physically separate locations.

b. CELLSAVE may assign and transfer any or all of its rights and obligations under this Service Agreement to any third party, for which the Client hereby gives consent. CELLSAVE will notify the Client in writing to that effect.

c. CELLSAVE does not give, nor does it purport to give, any medical advice, or otherwise perform any other function for the Client other than the services expressly described in this Service Agreement.

d. Client hereby consents to the collection, transport, and testing of the Specimen and to the processing, cryopreservation, and storage of the Specimen in and to a Unit as stated by this Service Agreement.

e. The Client’s right to storage and release of the Product is subject to the timely and full payment of all Fees by the Client in accordance with this Service Agreement.

6. TERMS AND TERMINATION:

These terms and conditions come into force on the date of receipt by CELLSAVE of the Service Agreement signed by the Client and will continue for the period mentioned in the Payment Plan from the date of the birth of the Child (the “Initial Storage Period”).

Six months prior to the end of the Initial Storage Period, an agreement can be made upon the mutual agreement of the Parties in the event that Client wishes CELLSAVE to continue to store the Product on their behalf for a further period (the “Extended Storage Period”), and such extended storage shall be at the market prices valid at that time. If 30 days before the expiry of this Service Agreement, Parties have not agreed to the terms of an Extended Storage Period of the Product, or upon the termination of this Service Agreement by CELLSAVE or the Client in accordance with this Clause 6, the Client relinquishes all rights in and waives all rights to the Product and CELLSAVE shall have the right to destroy the Product.

This Service Agreement may be terminated prior to its term by written notice with immediate effect:

a. By Client at any time prior to the collection of the Specimen. In this case, a minimal fee will be charged as indicated in the Fee Schedule in Section C.

b. By CELLSAVE if the Specimen and/or Product are not suitable for storage, whether for medical, safety, practical, or any other reason, as determined by CELLSAVE in its sole and absolute discretion (e.g. the Specimen is received by CELLSAVE more than 72 hours after the birth of the Child; the Specimen is damaged; the collected Specimen volume is too small). In these situations, CELLSAVE will not store the Specimen and/or CELLSAVE retains the sole right to make this decision.

c. By CELLSAVE if CELLSAVE does not receive the Enrollment Fee and/or Processing and Storage Fee within the specific time.

Termination of this Service Agreement under clause 6c above will not affect the Client’s responsibility for payment in full of all amounts invoiced and of all additional administrative and legal costs related to collecting the outstanding amounts. On termination of this Service Agreement, CELLSAVE reserves the right to destroy the Specimen and/or the Product.

7. RIGHTS TO PRODUCT:

Unless otherwise defined by applicable law, the Product remains the property of the Child throughout the term of this Agreement. Until the Child reaches legal age, the Client has the right and responsibility to consent to the collection, storage, use, and disposal of the Product on behalf of the Child.

8. RELEASE REQUEST:

In the event that the Product is required for treatment or manufacturing of a medicinal product, the Client shall provide written notification of the same to CELLSAVE. Any request for release has to be addressed to CELLSAVE Arabia, P.O. Box 505152, Dubai Healthcare City, Dubai, UAE, to the attention of the Medical Director, or to the e-mail address infoarabia@cellsave.com. The notice shall include the name and address of the physician and hospital to which the Product must be sent or the appropriately accredited Current Good Manufacturing Practices (cGMP) manufacturer. CELLSAVE shall then provide the authorized hospital or manufacturer with a release form (the “Release Form”) which must be returned to CELLSAVE. CELLSAVE will arrange for transport of the Product to the hospital, on the Client’s behalf.

CELLSAVE expressly excludes all liability for the transportation of the Product conducted by a third party.

CELLSAVE will not charge the Client any costs involved with the transport of the Product to the destination indicated on the Release Form.

9. ACKNOWLEDGEMENT:

The Client understands that the actual collection of the Specimen by the physician, obstetrician, or other medical staff at the birth of the Child is not part of the Service and that the relevant doctor, obstetrician, or other medical staff may under certain circumstances refuse, be unable or fail to collect and/or adequately pack the Specimen and that neither CELLSAVE nor its officers, shareholders, employees, agents, and contractors bear any responsibility for any mistakes or damages caused by such doctor, obstetrician or other medical staff.

The Client also understands and confirms that CELLSAVE, its officers, directors, employees, shareholders, agents, and consultants have not made any representations and bear no responsibilities and obligations with respect to the possibility to collect Stem Cells successfully from the Specimen, the suitability of the Stem Cells for the contemplated treatment, the successful treatment of any diseases through Stem Cell transplantation or therapies, and the advantages of umbilical Cord Blood Stem Cell usage over other therapies using Stem Cells.

10. LIMITATION OF LIABILITY:

CELLSAVE’s responsibility towards the Client and/or the Child whose Product/s are being stored is limited to the Service described in this Service agreement. Client agrees that should he/she/they make any claim against CELLSAVE, CELLSAVE’s liability shall, to the extent allowed under applicable law, regardless of the basis of such claim, whether in contract, tort or otherwise, be limited in total and in aggregate to (a) the amount of the Fee paid by the Client to CELLSAVE under this Service Agreement, or (b) in the event of CELLSAVE’s negligence, the amount permitted to be recovered by CELLSAVE under the malpractice insurance maintained by CELLSAVE in connection with such claims.

11. DATA PROTECTION:

The Client agrees to the processing and storage of personal data (including personal data of the Child and the mother and father of the Child), by CELLSAVE or its agent, affiliate, or subcontractor, which has come to CELLSAVE’s knowledge in the course of performing the Services and otherwise under this Service Agreement. The Client agrees and permits CELLSAVE to inform the status of infectious disease report of the mother of the Child and the Cord Blood and Cord Tissue and/or Placental Tissue/Amnion Placental Tissue/Cord Vessel to the United Arab Emirates Government regulatory agencies including the Ministry of Health, the Dubai Health Authority, Dubai Healthcare City Authority or any other agency mandated under United Arab Emirates laws or under any other law to which CELLSAVE is subject.

CELLSAVE will use the Client’s personal data only to the extent required by its contractual obligations hereunder and in accordance with the applicable laws and regulations of the United Arab Emirates.

12. FORCE MAJEURE:

CELLSAVE cannot be held liable for, and expressly excludes all liability for, any possible loss or damage due to natural disasters, an act of war or terror, riot, strike, vandalism, acts or omission of authorities, or any events beyond CELLSAVE‘s control which cause destruction of, or deterioration to the Specimen and/or Product.

13. NOTICE:

If the Client needs to send CELLSAVE any notices or communications under the Service Agreement, the Client must send them in writing by first-class or registered post/recorded delivery to the CELLSAVE address as set out in Section 13 below or any alternative address that CELLSAVE notification to the Client.

If CELLSAVE needs to send the Client any notices or communications under the Service Agreement CELLSAVE will send them in writing by first-class or registered post/recorded delivery to the Client’s address as notified by the Client to CELLSAVE on page 1. The Client shall as soon as possible notify CELLSAVE in writing of any changes in the information provided, including relocation and/or change of address. All notifications to CELLSAVE shall be sent to CELLSAVE Arabia, P.O. Box 505152, Dubai Healthcare City, Al Razi Medical Complex 64, Dubai, UAE, or to the e-mail address: infoarabia@cellsave.com. CELLSAVE may completely rely on the data made available in writing by the Client, without any obligation to make further inquiries with respect to the correctness or actuality of such data.

14. COMPLIANCE WITH UAE LAWS AND REGULATIONS:

CELLSAVE operates and exists in the United Arab Emirates and thus is required to comply with the laws of the United Arab Emirates and the regulatory and legal requirements of governmental agencies such as the Ministry of Health, the Dubai Health Authority, and the Dubai Healthcare City Authority. The Client hereby agrees that CELLSAVE may take any action required by it in order to comply with the laws of the United Arab Emirates, as well as the regulatory and legal requirements of governmental agencies such as the Ministry of Health, the Dubai Health Authority, and the Dubai Healthcare City.

15. GOVERNING LAW:

This Service Agreement shall be governed by, and construed in accordance with, the laws of United Arab Emirates. The Parties may bring suit in any court of competent jurisdiction.

16. ELECTRONIC COMMUNICATION:

a. The Client(s) acknowledges that this agreement does not infringe any provision of the Federal Law No. (1) on Electronic Commerce and Transactions, of 2006.

b. This agreement shall constitute a valid and binding agreement in accordance with Article 18 of the Federal Law No. (1) on Electronic Commerce and Transactions of 2006. No written confirmation or reciprocal signature by the Client(s) and/or CELLSAVE is required to give effect to the rights and obligations established by the Service Agreement.

17. HEADINGS:

The headings contained in this Service Agreement are for reference purposes only and shall not affect the meaning or interpretation of this Service Agreement.

18. SEVERABILITY:

Should any provision of this Service Agreement be invalid or unenforceable or should this Service Agreement contain an omission, the remaining provisions shall remain valid. In the place of an invalid provision or an omission, a new, valid provision – which comes economically closest to the one actually agreed upon provision or, in the event of an omission, the intentions set forth in this Service Agreement – is presumed to be agreed upon by the Parties.

19. ENTIRE AGREEMENT:

This Service Agreement constitutes the entire understanding between the Parties with respect to the subject matter of this Service Agreement and supersedes all prior agreements, negotiations, and discussions between the Parties relating to it.

20. AMENDMENT:

Neither Party can change or amend the terms of this Service Agreement without the prior written approval of the other Party.

 

B. INFORMED CONSENT

I/We on behalf of my/our unborn Child wish to enroll in the Umbilical Cord Blood and Cord Tissue (and/or, if applicable, Placental Tissue/Amnion Placental Tissue/Cord Vessel) banking service offered by CELLSAVE. The Specimen will be uniquely identified, stored, and maintained at a cryogenic storage facility. CELLSAVE will retrieve these cells at my/our request as per the Service Agreement. I/We agree to its terms of understanding as outlined below, and consent to have the Service performed.

I/We understand that collection and storing my/our newborn’s Stem Cells may potentially benefit my/our Child should he or she need them in the future to treat certain diseases. I/We understand that it is not possible to determine whether my/our Child will develop a disease in the future that can be treated with these cells. I/We understand that these newborn Stem Cells are a perfect match for my/our Child and, while there is no guarantee my/our child will ever need them, the fact that they are a perfect match can reduce serious complications should cell therapy ever be needed. I/We understand that my Child’s cells may be suitable for use by other family members.

I/We understand that, although infrequent, complications may occur at birth, and it may not be possible to collect Cord Blood and Cord Tissue (and/or, if applicable, Placental Tissue/ Amnion Placental Tissue /Cord Vessel) from my/our Child. Therefore, collection of Cord Blood and Cord Tissue (and/ or, if applicable, Placental Tissue/ Amnion Placental Tissue/Cord Vessel) from my/our Child cannot be guaranteed as its collection is arranged between my/ our physician/midwife and me/us. My/Our health and the health of my/our newborn is my/our physician/midwife’s first priority. I/We agree that my/our physician/midwife’s judgment shall be absolute and final.

I/We understand that CELLSAVE will perform cell viability, cell counts, blood typing, and bacterial and fungal tests on the Cord Blood and Cord Tissue (and/or, if applicable, Placental Tissue/ Amnion Placental Tissue /Cord Vessel) to determine the nature and quality of the Cord Blood and Cord Tissue (and/or, if applicable, Placental Tissue/ Amnion Placental Tissue/Cord Vessel). I/We understand that regulatory and accreditation associations require certain tests and I/we fully consent to provide the Maternal Blood Test. I/We consent to the use of a sample from the blood of the mother of the Child to be tested for certain infectious diseases . This is in accordance with the AABB, EU and International Directives, guidelines for tissue banks, and as otherwise required under the laws of the United Arab Emirates.

I/We understand that if the test results of the sample are confirmed positive for HIV, the Cord Blood and Cord Tissue (and/or, if applicable, Placental Tissue/ Amnion Placental Tissue /Cord Vessel) will not be stored. I/We understand that if the tests indicate the possible presence of hepatitis B or C, syphilis, or if my responses to the health questionnaire indicate a risk of one of these infections, my/our Child’s Cord Blood and Cord Tissue (and/or, if applicable, Placental Tissue/ Amnion Placental Tissue /Cord Vessel) will be processed and cryopreserved only with the approval of the CELLSAVE Medical Director. Based on the review of these results, I/we understand that CELLSAVE may decide not to permanently store the Cord Blood and Cord Tissue (and/or, if applicable, Placental Tissue/ Amnion Placental Tissue/Cord Vessel). If this occurs, I/we will be notified in writing of this decision. I/We authorize CELLSAVE to provide me with test results and to furnish them to my primary physician, my partner, or/and to government agencies as only required by law. If the Maternal Blood Test is positive for one of the infectious diseases tested for, the Client(s) should sign a continuation form provided by CELLSAVE.

I/We understand that CELLSAVE will follow the United Arab Emirates regulations and will follow the same regulations for Cord Blood, Cord Tissue, Placental Tissue, Amnion Placental Tissue/Cord Vessel collection, and the Maternal Blood Test. I/We understand that as per the regulations of the United Arab Emirates, CELLSAVE processes and cryopreserves Cord Blood, Cord Tissue, Placental Tissue, Amnion Placental Tissue, and Cord Vessel collected from full-term live babies only, and does not process or cryopreserve Cord Blood, Cord Tissue, Placental Tissue, Amnion Placental Tissue, and Cord Vessel collected from an abortus. I/We understand that the Client(s) are responsible for the barcodes provided to him/her/them and issued by CELLSAVE.

 

Please tick below to agree.

Code: C.2.50-4B/V1 CSA Agreement-English

 

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Signature Certificate
Document name: Service Agreement - Test
lock iconUnique Document ID: 7ea34890651ed8f0c09d70bb4854d99bd0ef016a
Timestamp Audit
September 13, 2023 4:51 pm +04Service Agreement - Test Uploaded by Cellsave Arabia - csait@cellsave.com IP 5.32.48.90