client.famicordcryobank.ch Open in urlscan Pro
212.180.230.18  Public Scan

URL: https://client.famicordcryobank.ch/en/client/km/step-1
Submission: On December 06 via api from RU — Scanned from CH

Form analysis 7 forms found in the DOM

<form>
  <fieldset>
    <legend class="visuallyhidden">Consent Selection</legend>
    <div id="CybotCookiebotDialogBodyFieldsetInnerContainer">
      <div class="CybotCookiebotDialogBodyLevelButtonWrapper"><label class="CybotCookiebotDialogBodyLevelButtonLabel" for="CybotCookiebotDialogBodyLevelButtonNecessary"><strong
            class="CybotCookiebotDialogBodyLevelButtonDescription">Notwendig</strong></label>
        <div class="CybotCookiebotDialogBodyLevelButtonSliderWrapper CybotCookiebotDialogBodyLevelButtonSliderWrapperDisabled"><input type="checkbox" id="CybotCookiebotDialogBodyLevelButtonNecessary"
            class="CybotCookiebotDialogBodyLevelButton CybotCookiebotDialogBodyLevelButtonDisabled" disabled="disabled" checked="checked"> <span class="CybotCookiebotDialogBodyLevelButtonSlider"></span></div>
      </div>
      <div class="CybotCookiebotDialogBodyLevelButtonWrapper"><label class="CybotCookiebotDialogBodyLevelButtonLabel" for="CybotCookiebotDialogBodyLevelButtonPreferences"><strong
            class="CybotCookiebotDialogBodyLevelButtonDescription">Präferenzen</strong></label>
        <div class="CybotCookiebotDialogBodyLevelButtonSliderWrapper"><input type="checkbox" id="CybotCookiebotDialogBodyLevelButtonPreferences" class="CybotCookiebotDialogBodyLevelButton CybotCookiebotDialogBodyLevelConsentCheckbox"
            data-target="CybotCookiebotDialogBodyLevelButtonPreferencesInline" checked="checked" tabindex="0"> <span class="CybotCookiebotDialogBodyLevelButtonSlider"></span></div>
      </div>
      <div class="CybotCookiebotDialogBodyLevelButtonWrapper"><label class="CybotCookiebotDialogBodyLevelButtonLabel" for="CybotCookiebotDialogBodyLevelButtonStatistics"><strong
            class="CybotCookiebotDialogBodyLevelButtonDescription">Statistiken</strong></label>
        <div class="CybotCookiebotDialogBodyLevelButtonSliderWrapper"><input type="checkbox" id="CybotCookiebotDialogBodyLevelButtonStatistics" class="CybotCookiebotDialogBodyLevelButton CybotCookiebotDialogBodyLevelConsentCheckbox"
            data-target="CybotCookiebotDialogBodyLevelButtonStatisticsInline" checked="checked" tabindex="0"> <span class="CybotCookiebotDialogBodyLevelButtonSlider"></span></div>
      </div>
      <div class="CybotCookiebotDialogBodyLevelButtonWrapper"><label class="CybotCookiebotDialogBodyLevelButtonLabel" for="CybotCookiebotDialogBodyLevelButtonMarketing"><strong
            class="CybotCookiebotDialogBodyLevelButtonDescription">Marketing</strong></label>
        <div class="CybotCookiebotDialogBodyLevelButtonSliderWrapper"><input type="checkbox" id="CybotCookiebotDialogBodyLevelButtonMarketing" class="CybotCookiebotDialogBodyLevelButton CybotCookiebotDialogBodyLevelConsentCheckbox"
            data-target="CybotCookiebotDialogBodyLevelButtonMarketingInline" checked="checked" tabindex="0"> <span class="CybotCookiebotDialogBodyLevelButtonSlider"></span></div>
      </div>
    </div>
  </fieldset>
</form>

<form><input type="checkbox" id="CybotCookiebotDialogBodyLevelButtonNecessaryInline" class="CybotCookiebotDialogBodyLevelButton CybotCookiebotDialogBodyLevelButtonDisabled" disabled="disabled" checked="checked"> <span
    class="CybotCookiebotDialogBodyLevelButtonSlider"></span></form>

<form><input type="checkbox" id="CybotCookiebotDialogBodyLevelButtonPreferencesInline" class="CybotCookiebotDialogBodyLevelButton CybotCookiebotDialogBodyLevelConsentCheckbox" data-target="CybotCookiebotDialogBodyLevelButtonPreferences"
    checked="checked" tabindex="0"> <span class="CybotCookiebotDialogBodyLevelButtonSlider"></span></form>

<form><input type="checkbox" id="CybotCookiebotDialogBodyLevelButtonStatisticsInline" class="CybotCookiebotDialogBodyLevelButton CybotCookiebotDialogBodyLevelConsentCheckbox" data-target="CybotCookiebotDialogBodyLevelButtonStatistics"
    checked="checked" tabindex="0"> <span class="CybotCookiebotDialogBodyLevelButtonSlider"></span></form>

<form><input type="checkbox" id="CybotCookiebotDialogBodyLevelButtonMarketingInline" class="CybotCookiebotDialogBodyLevelButton CybotCookiebotDialogBodyLevelConsentCheckbox" data-target="CybotCookiebotDialogBodyLevelButtonMarketing" checked="checked"
    tabindex="0"> <span class="CybotCookiebotDialogBodyLevelButtonSlider"></span></form>

<form class="CybotCookiebotDialogBodyLevelButtonSliderWrapper"><input type="checkbox" id="CybotCookiebotDialogBodyContentCheckboxPersonalInformation" class="CybotCookiebotDialogBodyLevelButton"> <span
    class="CybotCookiebotDialogBodyLevelButtonSlider"></span></form>

Name: app_conversion_path_second_stepPOST /en/client/km/step-1

<form name="app_conversion_path_second_step" method="post" action="/en/client/km/step-1" data-calc-url="/en/client/km/calculate" data-deci-url="/en/client/km/step-1-decision" data-addons-validate-url="/en/client/additional-packages/validate"
  novalidate="novalidate" footer_bar="">
  <div id="second-step-path">
    <div class="grey-box">
      <div class="container">
        <div class="row justify-content-center">
          <div class="col-lg-8">
            <div class="country-of-origin">
              <h2>1. Where are you from?</h2>
              <select id="app_conversion_path_second_step_countryOfOriginCode" name="app_conversion_path_second_step[countryOfOriginCode]" required="required" class="select-2 select2-hidden-accessible"
                data-select2-id="app_conversion_path_second_step_countryOfOriginCode" tabindex="-1" aria-hidden="true">
                <option value="" selected="selected" data-select2-id="4">Choose an option</option>
                <option value="AT">Austria</option>
                <option value="BG">Bulgaria</option>
                <option value="CZ">Czechia</option>
                <option value="DE">Germany</option>
                <option value="ES">Spain</option>
                <option value="FR">France</option>
                <option value="HU">Hungary</option>
                <option value="IT">Italy</option>
                <option value="PT">Portugal</option>
                <option value="RS">Serbia</option>
                <option value="SK">Slovakia</option>
                <option disabled="disabled">-------------------</option>
                <option value="AD">Andorra</option>
                <option value="AE">United Arab Emirates</option>
                <option value="AF">Afghanistan</option>
                <option value="AG">Antigua &amp; Barbuda</option>
                <option value="AI">Anguilla</option>
                <option value="AL">Albania</option>
                <option value="AM">Armenia</option>
                <option value="AO">Angola</option>
                <option value="AQ">Antarctica</option>
                <option value="AR">Argentina</option>
                <option value="AS">American Samoa</option>
                <option value="AT">Austria</option>
                <option value="AU">Australia</option>
                <option value="AW">Aruba</option>
                <option value="AX">Åland Islands</option>
                <option value="AZ">Azerbaijan</option>
                <option value="BA">Bosnia &amp; Herzegovina</option>
                <option value="BB">Barbados</option>
                <option value="BD">Bangladesh</option>
                <option value="BE">Belgium</option>
                <option value="BF">Burkina Faso</option>
                <option value="BG">Bulgaria</option>
                <option value="BH">Bahrain</option>
                <option value="BI">Burundi</option>
                <option value="BJ">Benin</option>
                <option value="BL">St. Barthélemy</option>
                <option value="BM">Bermuda</option>
                <option value="BN">Brunei</option>
                <option value="BO">Bolivia</option>
                <option value="BQ">Caribbean Netherlands</option>
                <option value="BR">Brazil</option>
                <option value="BS">Bahamas</option>
                <option value="BT">Bhutan</option>
                <option value="BV">Bouvet Island</option>
                <option value="BW">Botswana</option>
                <option value="BY">Belarus</option>
                <option value="BZ">Belize</option>
                <option value="CA">Canada</option>
                <option value="CC">Cocos (Keeling) Islands</option>
                <option value="CD">Congo - Kinshasa</option>
                <option value="CF">Central African Republic</option>
                <option value="CG">Congo - Brazzaville</option>
                <option value="CH">Switzerland</option>
                <option value="CI">Côte d’Ivoire</option>
                <option value="CK">Cook Islands</option>
                <option value="CL">Chile</option>
                <option value="CM">Cameroon</option>
                <option value="CN">China</option>
                <option value="CO">Colombia</option>
                <option value="CR">Costa Rica</option>
                <option value="CU">Cuba</option>
                <option value="CV">Cape Verde</option>
                <option value="CW">Curaçao</option>
                <option value="CX">Christmas Island</option>
                <option value="CY">Cyprus</option>
                <option value="CZ">Czechia</option>
                <option value="DE">Germany</option>
                <option value="DJ">Djibouti</option>
                <option value="DK">Denmark</option>
                <option value="DM">Dominica</option>
                <option value="DO">Dominican Republic</option>
                <option value="DZ">Algeria</option>
                <option value="EC">Ecuador</option>
                <option value="EE">Estonia</option>
                <option value="EG">Egypt</option>
                <option value="EH">Western Sahara</option>
                <option value="ER">Eritrea</option>
                <option value="ES">Spain</option>
                <option value="ET">Ethiopia</option>
                <option value="FI">Finland</option>
                <option value="FJ">Fiji</option>
                <option value="FK">Falkland Islands</option>
                <option value="FM">Micronesia</option>
                <option value="FO">Faroe Islands</option>
                <option value="FR">France</option>
                <option value="GA">Gabon</option>
                <option value="GB">United Kingdom</option>
                <option value="GD">Grenada</option>
                <option value="GE">Georgia</option>
                <option value="GF">French Guiana</option>
                <option value="GG">Guernsey</option>
                <option value="GH">Ghana</option>
                <option value="GI">Gibraltar</option>
                <option value="GL">Greenland</option>
                <option value="GM">Gambia</option>
                <option value="GN">Guinea</option>
                <option value="GP">Guadeloupe</option>
                <option value="GQ">Equatorial Guinea</option>
                <option value="GR">Greece</option>
                <option value="GS">South Georgia &amp; South Sandwich Islands</option>
                <option value="GT">Guatemala</option>
                <option value="GU">Guam</option>
                <option value="GW">Guinea-Bissau</option>
                <option value="GY">Guyana</option>
                <option value="HK">Hong Kong SAR China</option>
                <option value="HM">Heard &amp; McDonald Islands</option>
                <option value="HN">Honduras</option>
                <option value="HR">Croatia</option>
                <option value="HT">Haiti</option>
                <option value="HU">Hungary</option>
                <option value="ID">Indonesia</option>
                <option value="IE">Ireland</option>
                <option value="IL">Israel</option>
                <option value="IM">Isle of Man</option>
                <option value="IN">India</option>
                <option value="IO">British Indian Ocean Territory</option>
                <option value="IQ">Iraq</option>
                <option value="IR">Iran</option>
                <option value="IS">Iceland</option>
                <option value="IT">Italy</option>
                <option value="JE">Jersey</option>
                <option value="JM">Jamaica</option>
                <option value="JO">Jordan</option>
                <option value="JP">Japan</option>
                <option value="KE">Kenya</option>
                <option value="KG">Kyrgyzstan</option>
                <option value="KH">Cambodia</option>
                <option value="KI">Kiribati</option>
                <option value="KM">Comoros</option>
                <option value="KN">St. Kitts &amp; Nevis</option>
                <option value="KP">North Korea</option>
                <option value="KR">South Korea</option>
                <option value="KW">Kuwait</option>
                <option value="KY">Cayman Islands</option>
                <option value="KZ">Kazakhstan</option>
                <option value="LA">Laos</option>
                <option value="LB">Lebanon</option>
                <option value="LC">St. Lucia</option>
                <option value="LI">Liechtenstein</option>
                <option value="LK">Sri Lanka</option>
                <option value="LR">Liberia</option>
                <option value="LS">Lesotho</option>
                <option value="LT">Lithuania</option>
                <option value="LU">Luxembourg</option>
                <option value="LV">Latvia</option>
                <option value="LY">Libya</option>
                <option value="MA">Morocco</option>
                <option value="MC">Monaco</option>
                <option value="MD">Moldova</option>
                <option value="ME">Montenegro</option>
                <option value="MF">St. Martin</option>
                <option value="MG">Madagascar</option>
                <option value="MH">Marshall Islands</option>
                <option value="MK">North Macedonia</option>
                <option value="ML">Mali</option>
                <option value="MM">Myanmar (Burma)</option>
                <option value="MN">Mongolia</option>
                <option value="MO">Macao SAR China</option>
                <option value="MP">Northern Mariana Islands</option>
                <option value="MQ">Martinique</option>
                <option value="MR">Mauritania</option>
                <option value="MS">Montserrat</option>
                <option value="MT">Malta</option>
                <option value="MU">Mauritius</option>
                <option value="MV">Maldives</option>
                <option value="MW">Malawi</option>
                <option value="MX">Mexico</option>
                <option value="MY">Malaysia</option>
                <option value="MZ">Mozambique</option>
                <option value="NA">Namibia</option>
                <option value="NC">New Caledonia</option>
                <option value="NE">Niger</option>
                <option value="NF">Norfolk Island</option>
                <option value="NG">Nigeria</option>
                <option value="NI">Nicaragua</option>
                <option value="NL">Netherlands</option>
                <option value="NO">Norway</option>
                <option value="NP">Nepal</option>
                <option value="NR">Nauru</option>
                <option value="NU">Niue</option>
                <option value="NZ">New Zealand</option>
                <option value="OM">Oman</option>
                <option value="PA">Panama</option>
                <option value="PE">Peru</option>
                <option value="PF">French Polynesia</option>
                <option value="PG">Papua New Guinea</option>
                <option value="PH">Philippines</option>
                <option value="PK">Pakistan</option>
                <option value="PL">Poland</option>
                <option value="PM">St. Pierre &amp; Miquelon</option>
                <option value="PN">Pitcairn Islands</option>
                <option value="PR">Puerto Rico</option>
                <option value="PS">Palestinian Territories</option>
                <option value="PT">Portugal</option>
                <option value="PW">Palau</option>
                <option value="PY">Paraguay</option>
                <option value="QA">Qatar</option>
                <option value="RE">Réunion</option>
                <option value="RO">Romania</option>
                <option value="RS">Serbia</option>
                <option value="RU">Russia</option>
                <option value="RW">Rwanda</option>
                <option value="SA">Saudi Arabia</option>
                <option value="SB">Solomon Islands</option>
                <option value="SC">Seychelles</option>
                <option value="SD">Sudan</option>
                <option value="SE">Sweden</option>
                <option value="SG">Singapore</option>
                <option value="SH">St. Helena</option>
                <option value="SI">Slovenia</option>
                <option value="SJ">Svalbard &amp; Jan Mayen</option>
                <option value="SK">Slovakia</option>
                <option value="SL">Sierra Leone</option>
                <option value="SM">San Marino</option>
                <option value="SN">Senegal</option>
                <option value="SO">Somalia</option>
                <option value="SR">Suriname</option>
                <option value="SS">South Sudan</option>
                <option value="ST">São Tomé &amp; Príncipe</option>
                <option value="SV">El Salvador</option>
                <option value="SX">Sint Maarten</option>
                <option value="SY">Syria</option>
                <option value="SZ">Eswatini</option>
                <option value="TC">Turks &amp; Caicos Islands</option>
                <option value="TD">Chad</option>
                <option value="TF">French Southern Territories</option>
                <option value="TG">Togo</option>
                <option value="TH">Thailand</option>
                <option value="TJ">Tajikistan</option>
                <option value="TK">Tokelau</option>
                <option value="TL">Timor-Leste</option>
                <option value="TM">Turkmenistan</option>
                <option value="TN">Tunisia</option>
                <option value="TO">Tonga</option>
                <option value="TR">Turkey</option>
                <option value="TT">Trinidad &amp; Tobago</option>
                <option value="TV">Tuvalu</option>
                <option value="TW">Taiwan</option>
                <option value="TZ">Tanzania</option>
                <option value="UA">Ukraine</option>
                <option value="UG">Uganda</option>
                <option value="UM">U.S. Outlying Islands</option>
                <option value="US">United States</option>
                <option value="UY">Uruguay</option>
                <option value="UZ">Uzbekistan</option>
                <option value="VA">Vatican City</option>
                <option value="VC">St. Vincent &amp; Grenadines</option>
                <option value="VE">Venezuela</option>
                <option value="VG">British Virgin Islands</option>
                <option value="VI">U.S. Virgin Islands</option>
                <option value="VN">Vietnam</option>
                <option value="VU">Vanuatu</option>
                <option value="WF">Wallis &amp; Futuna</option>
                <option value="WS">Samoa</option>
                <option value="XK">Kosovo</option>
                <option value="YE">Yemen</option>
                <option value="YT">Mayotte</option>
                <option value="ZA">South Africa</option>
                <option value="ZM">Zambia</option>
                <option value="ZW">Zimbabwe</option>
              </select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="3" style="width: 100%;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
                    aria-haspopup="true" aria-expanded="false" tabindex="0" aria-labelledby="select2-app_conversion_path_second_step_countryOfOriginCode-container"><span class="select2-selection__rendered"
                      id="select2-app_conversion_path_second_step_countryOfOriginCode-container" role="textbox" aria-readonly="true" title="Choose an option">Choose an option</span><span class="select2-selection__arrow"
                      role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
            </div>
          </div>
        </div>
        <div class="row justify-content-center">
          <div class="col-lg-8">
            <div class="language-choice">
              <h2>2. Select the language of the contract</h2>
              <select id="app_conversion_path_second_step_languageSupport" name="app_conversion_path_second_step[languageSupport]" required="required" class="select-2 no-search-bar select2-hidden-accessible"
                data-select2-id="app_conversion_path_second_step_languageSupport" tabindex="-1" aria-hidden="true">
                <option value="" selected="selected" data-select2-id="6">Choose an option</option>
                <option value="bg">Bulgarian</option>
                <option value="en">English</option>
                <option value="de">German</option>
                <option value="hu">Hungarian</option>
                <option value="it_genico">Italian for GENICO</option>
                <option value="it">Italian</option>
                <option value="es">Spanish</option>
                <option value="rs">Serbian</option>
              </select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="5" style="width: 100%;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
                    aria-haspopup="true" aria-expanded="false" tabindex="0" aria-labelledby="select2-app_conversion_path_second_step_languageSupport-container"><span class="select2-selection__rendered"
                      id="select2-app_conversion_path_second_step_languageSupport-container" role="textbox" aria-readonly="true" title="Choose an option">Choose an option</span><span class="select2-selection__arrow"
                      role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
            </div>
          </div>
        </div>
      </div>
    </div>
    <div class="storage-years-box grey-box">
      <div class="container">
        <div class="row justify-content-center">
          <div class="col-lg-8">
            <div class="row variants">
              <div id="app_conversion_path_second_step_storageYearsPaid" class="col-md-12">
                <h2> 3. For how many years of storage of the Child's material have you paid to initial cryo preservation provider?</h2>
                <p class="subheader">The parents declare that they have made a full prepayment for storage of the Biological Material pursuant to the agreement between the Parents and initial cryo preservation provider (or its legal predecessor,
                  affiliate, subcontractor or business partner) for:</p>
                <label class="inputs-container cryo-years" for="app_conversion_path_second_step_storageYearsPaid_0">
                  <div class="inputs">
                    <input type="radio" id="app_conversion_path_second_step_storageYearsPaid_0" name="app_conversion_path_second_step[storageYearsPaid]" required="required" data-var="service" value="1">
                    <label class="choose" for="app_conversion_path_second_step_storageYearsPaid_0">1 year</label>
                    <label class="chosen" for="app_conversion_path_second_step_storageYearsPaid_0">1 year </label>
                    <div class="check"></div>
                    <div class="inputs--bg"></div>
                  </div>
                </label>
                <label class="inputs-container cryo-years" for="app_conversion_path_second_step_storageYearsPaid_1">
                  <div class="inputs">
                    <input type="radio" id="app_conversion_path_second_step_storageYearsPaid_1" name="app_conversion_path_second_step[storageYearsPaid]" required="required" data-var="service" value="20">
                    <label class="choose" for="app_conversion_path_second_step_storageYearsPaid_1">20 years</label>
                    <label class="chosen" for="app_conversion_path_second_step_storageYearsPaid_1">20 years </label>
                    <div class="check"></div>
                    <div class="inputs--bg"></div>
                  </div>
                </label>
                <label class="inputs-container cryo-years" for="app_conversion_path_second_step_storageYearsPaid_2">
                  <div class="inputs">
                    <input type="radio" id="app_conversion_path_second_step_storageYearsPaid_2" name="app_conversion_path_second_step[storageYearsPaid]" required="required" data-var="service" value="25">
                    <label class="choose" for="app_conversion_path_second_step_storageYearsPaid_2">25 years*</label>
                    <label class="chosen" for="app_conversion_path_second_step_storageYearsPaid_2">25 years* </label>
                    <div class="check"></div>
                    <div class="inputs--bg"></div>
                  </div>
                </label>
                <label class="inputs-container cryo-years" for="app_conversion_path_second_step_storageYearsPaid_3">
                  <div class="inputs">
                    <input type="radio" id="app_conversion_path_second_step_storageYearsPaid_3" name="app_conversion_path_second_step[storageYearsPaid]" required="required" data-var="service" value="30">
                    <label class="choose" for="app_conversion_path_second_step_storageYearsPaid_3">30 years*</label>
                    <label class="chosen" for="app_conversion_path_second_step_storageYearsPaid_3">30 years* </label>
                    <div class="check"></div>
                    <div class="inputs--bg"></div>
                  </div>
                </label>
                <label class="inputs-container cryo-years" for="app_conversion_path_second_step_storageYearsPaid_4">
                  <div class="inputs">
                    <input type="radio" id="app_conversion_path_second_step_storageYearsPaid_4" name="app_conversion_path_second_step[storageYearsPaid]" required="required" data-var="service" value="35">
                    <label class="choose" for="app_conversion_path_second_step_storageYearsPaid_4">35 years*</label>
                    <label class="chosen" for="app_conversion_path_second_step_storageYearsPaid_4">35 years* </label>
                    <div class="check"></div>
                    <div class="inputs--bg"></div>
                  </div>
                </label>
                <label class="inputs-container cryo-years" for="app_conversion_path_second_step_storageYearsPaid_5">
                  <div class="inputs other">
                    <input type="radio" id="app_conversion_path_second_step_storageYearsPaid_5" name="app_conversion_path_second_step[storageYearsPaid]" required="required" data-var="service" value="-1">
                    <label class="choose" for="app_conversion_path_second_step_storageYearsPaid_5">Other?*</label>
                    <label class="chosen" for="app_conversion_path_second_step_storageYearsPaid_5">Other?* <div class="storageYearsPaidOther">
                      </div>
                    </label>
                    <div class="check"></div>
                    <div class="inputs--bg"></div>
                  </div>
                </label>
                <p class="additional-info">*FCS reserves the right to verify information and could ask Parents to send copy of contract with initial cryo preservation provider or confirmation of payment</p>
              </div>
            </div>
            <div class="row variants prepayments-row">
              <div id="app_conversion_path_second_step_prepayment">
                <label class="inputs-container prepayment" for="app_conversion_path_second_step_prepayment_0">
                  <div class="inputs">
                    <input type="radio" id="app_conversion_path_second_step_prepayment_0" name="app_conversion_path_second_step[prepayment]" required="required" data-var="service" data-az="insurance" value="partial">
                    <label class="choose" for="app_conversion_path_second_step_prepayment_0">Have made a partial prepayment for storage of the Biological Material pursuant to the agreement between the Parents and initial cryo preservation provider
                      (or its legal predecessor, affiliate, subcontractor or business partner)</label>
                    <label class="chosen" for="app_conversion_path_second_step_prepayment_0">Have made a partial prepayment for storage of the Biological Material pursuant to the agreement between the Parents and initial cryo preservation provider
                      (or its legal predecessor, affiliate, subcontractor or business partner)</label>
                    <div class="check"></div>
                    <div class="inputs--bg"></div>
                  </div>
                </label>
                <label class="inputs-container prepayment" for="app_conversion_path_second_step_prepayment_1">
                  <div class="inputs">
                    <input type="radio" id="app_conversion_path_second_step_prepayment_1" name="app_conversion_path_second_step[prepayment]" required="required" data-var="service" data-az="insurance" value="full">
                    <label class="choose" for="app_conversion_path_second_step_prepayment_1">Have made a full prepayment for storage of the Biological Material pursuant to the agreement between the Parents and initial cryo preservation provider (or
                      its legal predecessor, affiliate, subcontractor or business partner)</label>
                    <label class="chosen" for="app_conversion_path_second_step_prepayment_1">Have made a full prepayment for storage of the Biological Material pursuant to the agreement between the Parents and initial cryo preservation provider (or
                      its legal predecessor, affiliate, subcontractor or business partner)</label>
                    <div class="check"></div>
                    <div class="inputs--bg"></div>
                  </div>
                </label>
              </div>
            </div>
          </div>
        </div>
      </div>
    </div>
    <div class="grey-box">
      <div class="container">
        <div class="row justify-content-center">
          <div class="col-lg-8">
            <div class="row variants material-row">
              <div id="app_conversion_path_second_step_material" class="col-md-12">
                <h2> 4. Choose a type of the stored material (for the child that the contract concerns)</h2>
                <div class="materials-container">
                  <label class="inputs-container material" for="app_conversion_path_second_step_material_0">
                    <div class="inputs">
                      <input type="radio" id="app_conversion_path_second_step_material_0" name="app_conversion_path_second_step[material]" required="required" data-var="service" value="cord_blood">
                      <label class="choose" for="app_conversion_path_second_step_material_0"> Cord blood</label>
                      <label class="chosen" for="app_conversion_path_second_step_material_0"> Cord blood</label>
                      <div class="check"></div>
                      <div class="inputs--bg"></div>
                    </div>
                  </label>
                  <label class="inputs-container material" for="app_conversion_path_second_step_material_1">
                    <div class="inputs">
                      <input type="radio" id="app_conversion_path_second_step_material_1" name="app_conversion_path_second_step[material]" required="required" data-var="service" value="cord_tissue">
                      <label class="choose" for="app_conversion_path_second_step_material_1"> Cord tissue</label>
                      <label class="chosen" for="app_conversion_path_second_step_material_1"> Cord tissue</label>
                      <div class="check"></div>
                      <div class="inputs--bg"></div>
                    </div>
                  </label>
                  <label class="inputs-container material" for="app_conversion_path_second_step_material_2">
                    <div class="inputs">
                      <input type="radio" id="app_conversion_path_second_step_material_2" name="app_conversion_path_second_step[material]" required="required" data-var="service" value="cord_blood+cord">
                      <label class="choose" for="app_conversion_path_second_step_material_2"> Cord blood and cord tissue</label>
                      <label class="chosen" for="app_conversion_path_second_step_material_2"> Cord blood and cord tissue</label>
                      <div class="check"></div>
                      <div class="inputs--bg"></div>
                    </div>
                  </label>
                </div>
              </div>
            </div>
          </div>
        </div>
      </div>
    </div>
    <div class="blue-container">
      <div class="container">
        <div class="row justify-content-center">
          <div class="col-lg-8"> <!-- Kolumna z wyborem -->
            <div class="abonament">
              <div id="app_conversion_path_second_step__storage">
                <h2>5. Choose how You prefer to pay for the storage <u>after the period You already paid will be over</u></h2>
                <p class="subheader"> You do not have to pay now anything. First payment will be due after the period indicated by You in step 3.<br>We recommend option of yearly payment. This gives You flexibility and comfort </p>
                <p class="subheader"><span class="orange-text"> The decision to change the selected payment form may be changed at your request at any time during the term of contract- just contact us! </span></p>
                <div class="row">
                  <div class="inputs range single col-lg-6 col-md-6">
                    <input type="radio" id="app_conversion_path_second_step__storage_1" name="app_conversion_path_second_step[_storage]" required="required" value="1">
                    <label class="choose" for="app_conversion_path_second_step__storage_1">
                      <div class="check"></div>
                      <p class="title">
                        <span class="years">Yearly payment for storage - preffered by our customers</span>
                      </p>
                      <div class="cost">
                        <p class="price">
                          <span class="slashed" style="display: none;">
                            <span id="storage.yearly_1_standard" style="display: none;">
                              <s>109</s>
                            </span> € </span>
                          <span id="storage.yearly_1">109€</span>
                        </p>
                      </div>
                    </label>
                    <label class="bg_label" for="app_conversion_path_second_step__storage_1">
                      <div class="inputs--bg"></div>
                    </label>
                  </div>
                  <div class="inputs range single col-lg-6 col-md-6">
                    <label class="choose other-options">
                      <p class="title">
                        <span lass="years"> other options </span>
                      </p>
                    </label>
                    <label class="bg_label">
                      <div class="inputs--bg"></div>
                    </label>
                  </div>
                </div>
                <div class="row storage-other-options">
                  <div class="inputs range single col-lg-6 col-md-6">
                    <input type="radio" id="app_conversion_path_second_step__storage_2" name="app_conversion_path_second_step[_storage]" required="required" value="2">
                    <label class="choose" for="app_conversion_path_second_step__storage_2">
                      <div class="check"></div>
                      <p class="title">
                        <span class="years">Prepayment for 5 years</span>
                      </p>
                      <div class="cost">
                        <p class="price">
                          <span class="slashed" style="display: none;">
                            <span id="storage.aot_fee_5y_1_standard" style="display: none;">
                              <s>515</s>
                            </span> € </span>
                          <span id="storage.aot_fee_5y_1"> 515€</span>
                        </p>
                      </div>
                    </label>
                    <label class="bg_label" for="app_conversion_path_second_step__storage_2">
                      <div class="inputs--bg"></div>
                    </label>
                  </div>
                  <div class="inputs range single col-lg-6 col-md-6">
                    <input type="radio" id="app_conversion_path_second_step__storage_3" name="app_conversion_path_second_step[_storage]" required="required" value="3">
                    <label class="choose" for="app_conversion_path_second_step__storage_3">
                      <div class="check"></div>
                      <p class="title">
                        <span class="years">Prepayment for 10 years</span>
                      </p>
                      <div class="cost">
                        <p class="price">
                          <span class="slashed" style="display: none;">
                            <span id="storage.aot_fee_10y_1_standard" style="display: none;">
                              <s>980</s>
                            </span> € </span>
                          <span id="storage.aot_fee_10y_1"> 980€</span>
                        </p>
                      </div>
                    </label>
                    <label class="bg_label" for="app_conversion_path_second_step__storage_3">
                      <div class="inputs--bg"></div>
                    </label>
                  </div>
                  <div class="inputs range single col-lg-6 col-md-6">
                    <input type="radio" id="app_conversion_path_second_step__storage_4" name="app_conversion_path_second_step[_storage]" required="required" value="4">
                    <label class="choose" for="app_conversion_path_second_step__storage_4">
                      <div class="check"></div>
                      <p class="title">
                        <span class="years">Prepayment for 20 years</span>
                      </p>
                      <div class="cost">
                        <p class="price">
                          <span class="slashed" style="display: none;">
                            <span id="storage.aot_fee_20y_1_standard" style="display: none;">
                              <s>1740</s>
                            </span> € </span>
                          <span id="storage.aot_fee_20y_1"> 1740€ </span>
                        </p>
                      </div>
                    </label>
                    <label class="bg_label" for="app_conversion_path_second_step__storage_4">
                      <div class="inputs--bg"></div>
                    </label>
                  </div>
                </div>
              </div>
            </div>
          </div>
        </div>
      </div>
    </div>
    <div class="blue-container">
      <div class="container">
        <div class="row justify-content-center">
          <div class="col-lg-8"> <!-- Kolumna z wyborem -->
            <div class="row variants transport-row">
              <div id="app_conversion_path_second_step_transferCountryCode" class="col-md-12">
                <h2> 6. Information about biological material (transfer)</h2>
                <p class="subheader"> Containers with the biological material of most of initial cryo preservation provider‘s customers have been safely transported to the PBKM FamiCord Group laboratory in Poland. You can choose another laboratory
                  from FamiCord Group where we can transport your biological material. </p>
                <p>
                  <a id="labs-link" href="javascript: void(0);">List of available laboratories                                <span class="chevron-right"></span></a>
                </p>
                <div id="labs-list" class="row">
                  <div class="col-xl-4 col-md-6">
                    <label class="inputs-container transfer-country" for="app_conversion_path_second_step_transferCountryCode_0">
                      <div class="inputs">
                        <input type="radio" id="app_conversion_path_second_step_transferCountryCode_0" name="app_conversion_path_second_step[transferCountryCode]" data-var="service" data-az="insurance" value="PL" checked="checked">
                        <label class="choose" for="app_conversion_path_second_step_transferCountryCode_0"> Poland <span class="asterisk">*</span><br>
                          <span class="transfer-price"> 0 € </span>
                        </label>
                        <label class="chosen" for="app_conversion_path_second_step_transferCountryCode_0"> Poland <span class="asterisk">*</span><br>
                          <span class="transfer-price"> 0 € </span>
                        </label>
                        <div class="check"></div>
                        <div class="inputs--bg"></div>
                      </div>
                    </label>
                  </div>
                  <div class="col-xl-4 col-md-6">
                    <label class="inputs-container transfer-country" for="app_conversion_path_second_step_transferCountryCode_1">
                      <div class="inputs">
                        <input type="radio" id="app_conversion_path_second_step_transferCountryCode_1" name="app_conversion_path_second_step[transferCountryCode]" data-var="service" data-az="insurance" value="DE">
                        <label class="choose" for="app_conversion_path_second_step_transferCountryCode_1"> Germany<br>
                          <span class="transfer-price"> 390 € </span>
                        </label>
                        <label class="chosen" for="app_conversion_path_second_step_transferCountryCode_1"> Germany<br>
                          <span class="transfer-price"> 390 € </span>
                        </label>
                        <div class="check"></div>
                        <div class="inputs--bg"></div>
                      </div>
                    </label>
                  </div>
                  <div class="col-xl-4 col-md-6">
                    <label class="inputs-container transfer-country" for="app_conversion_path_second_step_transferCountryCode_2">
                      <div class="inputs">
                        <input type="radio" id="app_conversion_path_second_step_transferCountryCode_2" name="app_conversion_path_second_step[transferCountryCode]" data-var="service" data-az="insurance" value="CH">
                        <label class="choose" for="app_conversion_path_second_step_transferCountryCode_2"> Switzerland<br>
                          <span class="transfer-price"> 390 € </span>
                        </label>
                        <label class="chosen" for="app_conversion_path_second_step_transferCountryCode_2"> Switzerland<br>
                          <span class="transfer-price"> 390 € </span>
                        </label>
                        <div class="check"></div>
                        <div class="inputs--bg"></div>
                      </div>
                    </label>
                  </div>
                  <div class="col-8">
                    <p class="asterisk-info">* - current storage location</p>
                  </div>
                  <div class="links col-4">
                    <a class="resignation">Clear selection</a>
                  </div>
                </div>
              </div>
            </div>
          </div>
        </div>
      </div>
    </div>
    <div class="blue-container">
      <div class="container">
        <div class="row justify-content-center">
          <div class="col-lg-8"> <!-- Kolumna z wyborem -->
            <div id="app_conversion_path_second_step__additionalPackages" class="additional">
              <h2>7. Adjust the services to your needs.</h2>
              <div class="option " id="optional-transplant">
                <input type="checkbox" id="app_conversion_path_second_step__additionalPackages_1" name="app_conversion_path_second_step[_additionalPackages][]" data-code="optional.transplant" data-blocking-package="optional-transplant_plus"
                  value="1">
                <label for="app_conversion_path_second_step__additionalPackages_1"> Transplant Assistance Package </label>
                <div class="open_icon">
                </div>
                <div class="price price-free" data-label="
                                                                                            Annual payment
                                            ">
                  <span id="optional.transplant"> 54 </span> €
                </div>
              </div>
              <div class="info">
                <p data-hide="Hide"> This package consists of additional services provided by us to You when there will be need to use sample for therapy. It includes free testing of sample, medical consultation and transport to any clinic worldwide.
                  <a target="_blank" href="https://famicordcryobank.ch/contact-for-clients-of-the-former-service-provider/contract-for-customers-whose-biological-material-is-stored-in-warsaw">
                                            You may find detailed conditions on our web page
                                        </a>
                </p>
              </div>
              <div class="option " id="optional-transplant_plus">
                <input type="checkbox" id="app_conversion_path_second_step__additionalPackages_2" name="app_conversion_path_second_step[_additionalPackages][]" data-code="optional.transplant_plus" data-blocking-package="optional-transplant"
                  value="2">
                <label for="app_conversion_path_second_step__additionalPackages_2"> Transplant Assistance Plus Package </label>
                <div class="open_icon">
                </div>
                <div class="price price-free" data-label="
                                                                                            Annual payment
                                            ">
                  <span id="optional.transplant_plus"> 64 </span> €
                </div>
              </div>
              <div class="info">
                <p data-hide="Hide"> The package will facilitate the use of umbilical cord blood stem cells and / or umbilical cord for treatment, both in standard indications (hematological and oncological diseases) as well as experimental therapy
                  in cerebral palsy and autism spectrum disorders. As part of the package, we provide coordination of formal matters related to treatment, perform the necessary tests before administering stem cells, transport them to the place of
                  application and cover the costs of hospital stay. <a target="_blank" href="https://famicordcryobank.ch/contact-for-clients-of-the-former-service-provider/contract-for-customers-whose-biological-material-is-stored-in-warsaw">
                                            You may find detailed conditions on our web page
                                        </a>
                </p>
              </div>
              <div class="option " id="optional-cord_tissue_isolation">
                <input type="checkbox" id="app_conversion_path_second_step__additionalPackages_4" name="app_conversion_path_second_step[_additionalPackages][]" data-code="optional.cord_tissue_isolation" data-blocking-package="" value="4">
                <label for="app_conversion_path_second_step__additionalPackages_4"> Cord Tissue Validation </label>
                <div class="open_icon">
                </div>
                <div class="price price-free" data-label="
                                                                                            One-time payment
                                            ">
                  <span id="optional.cord_tissue_isolation"> 490 </span> €
                </div>
              </div>
              <div class="info">
                <p data-hide="Hide"> This package allows you to check if there are live mesenchymal cells in the stored umbilical cord. <a target="_blank" href="https://famicordcryobank.ch/contact-for-clients-of-the-former-service-provider/contract-for-customers-whose-biological-material-is-stored-in-warsaw">
                                            You may find detailed conditions on our web page
                                        </a>
                </p>
              </div>
              <div class="option disabled striked" id="optional-price_guarantee">
                <input type="checkbox" id="app_conversion_path_second_step__additionalPackages_5" name="app_conversion_path_second_step[_additionalPackages][]" data-code="optional.price_guarantee" data-blocking-package="" disabled="" value="5">
                <label for="app_conversion_path_second_step__additionalPackages_5"> Price Guarantee </label>
                <div class="open_icon">
                </div>
                <div class="price price-free" data-label="
                                                                                            One-time payment
                                            ">
                  <span id="optional.price_guarantee"> 190 </span> €
                </div>
              </div>
              <div class="info">
                <p data-hide="Hide"> This package gives you the guarantee that the price for annual storage will not change within 10 years from the end of the prepayment made to the former service provider and that the annual fees for the Transplant
                  Assistance or Transplant Assistance Plus packages will not change within 10 years of signing the contract. <a target="_blank" href="https://famicordcryobank.ch/services">
                                            You may find detailed conditions on our web page
                                        </a>
                </p>
              </div>
              <div id="app_conversion_path_second_step__additionalPackagesValidate" style="display: none">
                <h2>Fill details to check availability</h2>
                <label for="app_conversion_path_second_step_cryosaveAgreementNumber">Initial cryo preservation provider‘s contract number</label>
                <input type="text" id="app_conversion_path_second_step_cryosaveAgreementNumber" name="app_conversion_path_second_step[cryosaveAgreementNumber]" placeholder="Initial cryo preservation provider" minlength="6" maxlength="14"
                  class="form-control">
                <div class="col-sm-12 center">
                  <button type="button" id="app_conversion_path_second_step_cryosaveAgreementNumberBtnCheck" name="app_conversion_path_second_step[cryosaveAgreementNumberBtnCheck]" data-label-default="verify" data-label-checking="in verification..."
                    class="btn btn-check-additional-packages btn--check">verify</button>
                  <div id="app_conversion_path_second_step__cryosaveAgreementNumber_error" class="errorBar" style="display: none">
                    <p>This value should not be blank.</p>
                  </div>
                </div>
              </div>
              <div class="info-service-not-available" style="display: none">
                <h2> To order a service, please contact customer service <a href="mailto:info@famicordcryobank.ch">
                                        info@famicordcryobank.ch                                    </a>
                </h2>
              </div>
              <div class="info-service-available" style="display: none">
                <h2 class="green">
                  <i class="fa fa-check"></i> You can purchase the selected add-ons
                </h2>
              </div>
              <div class="info-service-invalid-cryosave" style="display: none">
                <h2 class="red">
                  <i class="fa fa-warning"></i> Incorrect Initial cryo preservation provider.
                </h2>
              </div>
            </div>
          </div>
        </div>
      </div>
    </div>
    <div class="container">
      <div class="row justify-content-center">
        <div class="col-lg-8 summaryColumn">
          <div class="col-sm-12 closeSummary">
          </div>
          <div class="fullSummary--column">
            <h3>Costs summary</h3>
            <div class="col-lg-12 text-center">
              <p class="getDiscount">
                <a id="second-step-pesel-show" href="javascript:void(0);" data-href="/en/client/km/step-1-identifier">
                            Already our customer?                            <span>Claim your discount!</span></a>
              </p>
            </div>
            <div class="cost--summary">
              <div class="divTable divTableRadiusNavy">
                <div class="divTableBody">
                  <div class="divTableRow">
                    <div class="divTableCell roundTopLeft width38 fontSize16 fontColorNavy colorWhite">Storage</div>
                    <div class="divTableCell roundTopRight width12 fontSize14 fontColorNavy colorWhite" id="storage_fee"> 0 <span class="currency">€</span>
                    </div>
                    <div class="divTableCell width50 fontSize16 fontColorWhite">Paid on completion of prepayment for initial cryo preservation provider.</div>
                  </div>
                  <div class="divTableRow">
                    <div class="divTableCell roundBottomLeft defaultLastRowLeft width38 fontSize16 fontColorNavy colorWhite borderDashedTop">Transfer fee</div>
                    <div class="divTableCell roundBottomRight defaultLastRowRight width12 fontSize14 fontColorNavy colorWhite borderDashedTop" id="transfer_fee"> 0 <span class="currency">€</span>
                    </div>
                    <div class="divTableCell width50 fontSize16 fontColorWhite borderDashedTop">Paid after transport</div>
                  </div>
                </div>
              </div>
              <div class="loader">
                <div class="spinner_wrapp">
                  <svg class="spinner" width="65px" height="65px" viewBox="0 0 66 66" xmlns="http://www.w3.org/2000/svg">
                    <circle class="path" fill="none" stroke-width="6" stroke-linecap="round" cx="33" cy="33" r="30"></circle>
                  </svg>
                </div>
              </div>
            </div>
          </div>
        </div>
      </div>
    </div>
  </div>
  <div class="container">
    <div class="row">
      <div class="col-sm-12 submit_foot">
        <div class="errorFooter">
        </div>
        <button id="conversion_path_submit" type="button" name="button" class="btn btn--submit">Continue <i class="fa fa-angle-right" aria-hidden="true"></i></button>
        <button type="button" class="btn btn--clean" id="clear-conversion-path-order">Clear the form, I want to start over </button>
      </div>
    </div>
  </div>
  <input type="hidden" id="app_conversion_path_second_step__confirmation" name="app_conversion_path_second_step[_confirmation]" value="$2y$10$y2RK9zO7wlO3xLeNuTlrneRx.zmAAyUB3ZwKQGsC7aaK5euc/ic.e"><input type="hidden"
    id="app_conversion_path_second_step__token" name="app_conversion_path_second_step[_token]" value="Ni_bw4vojaL0V0wiYzlEtSp5zED9i72BUlfb16Z-LiQ">
</form>

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IF YOU ARE A CLIENT OF CRYOSAVE ARABIA FZ-LLC OR CELLSAVE ARABIA FZ-LLC
THE BELOW INFORMATION DOES NOT CONCERN YOU.


YOU ARE 3 STEPS AWAY FROM CONCLUDING A CONTRACT WITH FAMICORD SUISSE.
YOU CAN CHECK THE TERMS OF THE CONTRACT HERE.

1 Offer
·······
2 Data
·······
3 Summary


1. WHERE ARE YOU FROM?

Choose an
optionAustriaBulgariaCzechiaGermanySpainFranceHungaryItalyPortugalSerbiaSlovakia-------------------AndorraUnited
Arab EmiratesAfghanistanAntigua &
BarbudaAnguillaAlbaniaArmeniaAngolaAntarcticaArgentinaAmerican
SamoaAustriaAustraliaArubaÅland IslandsAzerbaijanBosnia &
HerzegovinaBarbadosBangladeshBelgiumBurkina FasoBulgariaBahrainBurundiBeninSt.
BarthélemyBermudaBruneiBoliviaCaribbean NetherlandsBrazilBahamasBhutanBouvet
IslandBotswanaBelarusBelizeCanadaCocos (Keeling) IslandsCongo - KinshasaCentral
African RepublicCongo - BrazzavilleSwitzerlandCôte d’IvoireCook
IslandsChileCameroonChinaColombiaCosta RicaCubaCape VerdeCuraçaoChristmas
IslandCyprusCzechiaGermanyDjiboutiDenmarkDominicaDominican
RepublicAlgeriaEcuadorEstoniaEgyptWestern
SaharaEritreaSpainEthiopiaFinlandFijiFalkland IslandsMicronesiaFaroe
IslandsFranceGabonUnited KingdomGrenadaGeorgiaFrench
GuianaGuernseyGhanaGibraltarGreenlandGambiaGuineaGuadeloupeEquatorial
GuineaGreeceSouth Georgia & South Sandwich
IslandsGuatemalaGuamGuinea-BissauGuyanaHong Kong SAR ChinaHeard & McDonald
IslandsHondurasCroatiaHaitiHungaryIndonesiaIrelandIsraelIsle of ManIndiaBritish
Indian Ocean
TerritoryIraqIranIcelandItalyJerseyJamaicaJordanJapanKenyaKyrgyzstanCambodiaKiribatiComorosSt.
Kitts & NevisNorth KoreaSouth KoreaKuwaitCayman IslandsKazakhstanLaosLebanonSt.
LuciaLiechtensteinSri
LankaLiberiaLesothoLithuaniaLuxembourgLatviaLibyaMoroccoMonacoMoldovaMontenegroSt.
MartinMadagascarMarshall IslandsNorth MacedoniaMaliMyanmar (Burma)MongoliaMacao
SAR ChinaNorthern Mariana
IslandsMartiniqueMauritaniaMontserratMaltaMauritiusMaldivesMalawiMexicoMalaysiaMozambiqueNamibiaNew
CaledoniaNigerNorfolk IslandNigeriaNicaraguaNetherlandsNorwayNepalNauruNiueNew
ZealandOmanPanamaPeruFrench PolynesiaPapua New
GuineaPhilippinesPakistanPolandSt. Pierre & MiquelonPitcairn IslandsPuerto
RicoPalestinian
TerritoriesPortugalPalauParaguayQatarRéunionRomaniaSerbiaRussiaRwandaSaudi
ArabiaSolomon IslandsSeychellesSudanSwedenSingaporeSt. HelenaSloveniaSvalbard &
Jan MayenSlovakiaSierra LeoneSan MarinoSenegalSomaliaSurinameSouth SudanSão Tomé
& PríncipeEl SalvadorSint MaartenSyriaEswatiniTurks & Caicos IslandsChadFrench
Southern
TerritoriesTogoThailandTajikistanTokelauTimor-LesteTurkmenistanTunisiaTongaTurkeyTrinidad
& TobagoTuvaluTaiwanTanzaniaUkraineUgandaU.S. Outlying IslandsUnited
StatesUruguayUzbekistanVatican CitySt. Vincent & GrenadinesVenezuelaBritish
Virgin IslandsU.S. Virgin IslandsVietnamVanuatuWallis &
FutunaSamoaKosovoYemenMayotteSouth AfricaZambiaZimbabweChoose an option


2. SELECT THE LANGUAGE OF THE CONTRACT

Choose an optionBulgarianEnglishGermanHungarianItalian for
GENICOItalianSpanishSerbianChoose an option


3. FOR HOW MANY YEARS OF STORAGE OF THE CHILD'S MATERIAL HAVE YOU PAID TO
INITIAL CRYO PRESERVATION PROVIDER?

The parents declare that they have made a full prepayment for storage of the
Biological Material pursuant to the agreement between the Parents and initial
cryo preservation provider (or its legal predecessor, affiliate, subcontractor
or business partner) for:

1 year 1 year


20 years 20 years


25 years* 25 years*


30 years* 30 years*


35 years* 35 years*


Other?* Other?*




*FCS reserves the right to verify information and could ask Parents to send copy
of contract with initial cryo preservation provider or confirmation of payment

Have made a partial prepayment for storage of the Biological Material pursuant
to the agreement between the Parents and initial cryo preservation provider (or
its legal predecessor, affiliate, subcontractor or business partner) Have made a
partial prepayment for storage of the Biological Material pursuant to the
agreement between the Parents and initial cryo preservation provider (or its
legal predecessor, affiliate, subcontractor or business partner)


Have made a full prepayment for storage of the Biological Material pursuant to
the agreement between the Parents and initial cryo preservation provider (or its
legal predecessor, affiliate, subcontractor or business partner) Have made a
full prepayment for storage of the Biological Material pursuant to the agreement
between the Parents and initial cryo preservation provider (or its legal
predecessor, affiliate, subcontractor or business partner)




4. CHOOSE A TYPE OF THE STORED MATERIAL (FOR THE CHILD THAT THE CONTRACT
CONCERNS)

Cord blood Cord blood


Cord tissue Cord tissue


Cord blood and cord tissue Cord blood and cord tissue




5. CHOOSE HOW YOU PREFER TO PAY FOR THE STORAGE AFTER THE PERIOD YOU ALREADY
PAID WILL BE OVER

You do not have to pay now anything. First payment will be due after the period
indicated by You in step 3.
We recommend option of yearly payment. This gives You flexibility and comfort

The decision to change the selected payment form may be changed at your request
at any time during the term of contract- just contact us!

Yearly payment for storage - preffered by our customers

109 € 109€



other options



Prepayment for 5 years

515 € 515€



Prepayment for 10 years

980 € 980€



Prepayment for 20 years

1740 € 1740€




6. INFORMATION ABOUT BIOLOGICAL MATERIAL (TRANSFER)

Containers with the biological material of most of initial cryo preservation
provider‘s customers have been safely transported to the PBKM FamiCord Group
laboratory in Poland. You can choose another laboratory from FamiCord Group
where we can transport your biological material.

List of available laboratories

Poland *
0 € Poland *
0 €


Germany
390 € Germany
390 €


Switzerland
390 € Switzerland
390 €



* - current storage location

Clear selection


7. ADJUST THE SERVICES TO YOUR NEEDS.

Transplant Assistance Package

54 €

This package consists of additional services provided by us to You when there
will be need to use sample for therapy. It includes free testing of sample,
medical consultation and transport to any clinic worldwide. You may find
detailed conditions on our web page

Transplant Assistance Plus Package

64 €

The package will facilitate the use of umbilical cord blood stem cells and / or
umbilical cord for treatment, both in standard indications (hematological and
oncological diseases) as well as experimental therapy in cerebral palsy and
autism spectrum disorders. As part of the package, we provide coordination of
formal matters related to treatment, perform the necessary tests before
administering stem cells, transport them to the place of application and cover
the costs of hospital stay. You may find detailed conditions on our web page

Cord Tissue Validation

490 €

This package allows you to check if there are live mesenchymal cells in the
stored umbilical cord. You may find detailed conditions on our web page

Price Guarantee

190 €

This package gives you the guarantee that the price for annual storage will not
change within 10 years from the end of the prepayment made to the former service
provider and that the annual fees for the Transplant Assistance or Transplant
Assistance Plus packages will not change within 10 years of signing the
contract. You may find detailed conditions on our web page


FILL DETAILS TO CHECK AVAILABILITY

Initial cryo preservation provider‘s contract number
verify

This value should not be blank.


TO ORDER A SERVICE, PLEASE CONTACT CUSTOMER SERVICE INFO@FAMICORDCRYOBANK.CH


YOU CAN PURCHASE THE SELECTED ADD-ONS


INCORRECT INITIAL CRYO PRESERVATION PROVIDER.


COSTS SUMMARY

Already our customer? Claim your discount!

Storage
0 €
Paid on completion of prepayment for initial cryo preservation provider.
Transfer fee
0 €
Paid after transport


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