Donor Questions

Thank You for Visiting BTI

Why Donating Your First Gift Matters

Right now, you’re growing a miracle. And right now, your miracle is surrounded by a powerful and protective barrier called amnion, an amazing and natural resource that can help heal and save lives.

After your baby is born, your little miracle no longer needs it, and sadly, this powerful resource is simply discarded as waste.

By donating your birth tissue, commonly called afterbirth, you can make a difference.

Who Can Donate

Any healthy, expectant person is eligible to donate.

Some medical conditions may disqualify a donor, for example, active cancer and/or infectious diseases.

Donating Is Easy

The donation process is easy and safe, poses no risk to you or your baby, and can help improve many lives. Here’s how it works:

Complete the questions below and submit. These questions are the same kind of questions asked when you donate blood or plasma.

After, a BTI representative will follow-up with you either by phone or email to schedule a short Zoom or phone call to complete the screening process.

Prior to delivery, a blood sample will be drawn to ensure you are healthy and do not have any infectious diseases.

After delivering your miracle, a BTI staff member will work with your delivery team to recover your afterbirth.

That’s it! Something so simple that can help so many — it’s a legacy that begins at birth and lasts a lifetime. 

Make a difference with your first gift and donate.

Donor Name *

First

Last

Best Way to Contact You *

• Phone
• Email
• Text

Phone *

Email *

Best Time to Contact You *

• Day
• Evening
• Weekend

Birth Process *

• Natural
• C-section

Donor Date of Birth *

Donor Age *

Donor Birth Place *

Occupation *

Current Gestational Age (Pregnancy in weeks) *

Projected Date of Birth *

Physician Name *

Practice or Clinic Name *

Approximate Date Prenatal Care Began *

Delivering Hospital *

Have you ever traveled or resided outside the US and Canada? *

• Yes
• No

If yes, where do you travel or reside, when you were there and how long were you there? *

Have you had or ever had a positive HIV, HEPB, HEPC, Syphillis? *

• Yes
• No

Have you EVER or do you have any major illnesses, syndrome or diseases such as: liver disease or hepatitis, lung disease (asthma, COPD, etc.), kidney disease, heart or circulatory disease, cancer (lymphoma, leukemia), metabolic bone disease, Lyme disease, neurological disease, seizures? *

• Yes
• No

If yes, explain. *

Do you currently or have you recently had an infection, cold, flu? *

• Yes
• No

Have you EVER had a sexually transmitted infection (STI) such as, gonorrhea, chlamydia, or genital ulcers, herpes, or (HPV) genital warts? *

• Yes
• No

If yes, is it currently active? *

• Yes
• No

Have you ever received a blood transfusion or been told you were not allowed to donate blood? *

• Yes
• No

If yes, explain. *

Comments or Questions

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