Form 2004 Form 2005 Form 2006
For each instance where:
Donor type = Non-NMDP unrelated cord blood unit
CRF track
F2400 ‘Was this donor used for any prior HCTs’ = No
X (donor) X (donor) X (recipient) X (for each product*)
For each instance where:
Donor type = Non-NMDP unrelated cord blood unit
TED track
F2400 ‘Was this donor used for any prior HCTs’ = No
X (donor) X (donor) X (recipient) X (for each product*)

*On the Pre-TED (2400) Form, ‘Specify the number of these products intended to achieve hematopoietic engraftment’ determines the number of HCT Infusion (2006) Forms generated

Last modified: Jul 14, 2021