Parsmedix Phlebotomist Booking Form
Quality Cord Blood / Maternal Blood Collections
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  • Partner's Contact details

    Please provide the contact details of your partner or carer.
  • Your Birth Plan details

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  • Payment Section

  • After Submitting this form you will be directed to our payment page where you can pay for your selected services on-line.

    You can Pay us in one of the three ways:

    1- Through PayPal
    2- By Debit/ Credit Card
    3- By On-line Banking

    We recommend the On-line Banking as there are no fees involved. Barclays Bank, Account Number: 53091295, Sort Code: 20-74-63, Parsmedix Limited
  • Terms and conditions

    For full details please see our terms and conditions on: http://www.parsmedix.co.uk/fulltnc.html


  • Declaration

    I have read and understood the terms and conditions of Parsmedix Limited above and I understand that by submitting this form I will be legally bound by it. If I am signing on behalf of the expecting mother, I, the undersigned confirm that I have permission and authority from her and fully understand and accept the terms and conditions of Parsmedix Limited.



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