This donor has passed a rigorous medical examination to ensure absolute safety. Our screening process includes strict testing for infectious diseases (HIV, Hepatitis B/C, STIs), an evaluation of lifestyle habits, and a general physical assessment. We confirm the donor is currently in excellent health and free from transmissible conditions.
Assess your vision without corrective contact lenses
Do you wear contact lenses or have you had corrective surgery?
If yes, describe a problem:
What is the condition of your teeth?
Have you ever had braces?
Do you use nicotine products?
Do you drink alcoholic beverages?
If yes, how much alcohol do you drink?
Describe your diet
Estimate the level of nutrition:
Do you have allergies?
If yes, describe what exactly you are allergic to:
What is your sexual orientation?
How many children do you have?
Age at the time of the first menstruation:
The interval between menstruation is:
Have there been cases of multiple pregnancies in the family:
Please provide information about your biological relatives (indicate only natural hair and eye color):
Relative
Height, cm
Weight, kg
Eye color
Natural hair color
Primary medical history
Mother:
Father:
Complete the table
Family (which relative has the disease)
Age
Cause of death
Disease
The age at which was diagnosed
| Have you ever been diagnosed with or suspected of having any neurological disease (including dementia or degenerative /demyelinating disease of the CNS or other neurological disease of unknown etiology)? | No |
| Have you or any of your sexual partners ever been diagnosed with or suspected of having West Nile Virus (based on symptoms and/or laboratory results or confirmed WNV viremia), experienced symptoms of WNV infection? | No |
| Have you ever been exposed to known or suspected HIV, Hepatitis B, Hepatitis C infected blood or body fluids through skin inoculation, open wounds, non-intact skin or mucous membranes? | No |
| Have you or any of your sexual partners has had sex in the preceding 12 months with a person known to have HIV, clinically active HBV or clinically active HCV? | No |
| Have you or any of your sexual partner(s) ever received, blood, blood components, blood products, or other human tissues that are known to be possible sources of blood-borne pathogens? | No |
| Have you or your sexual partners been diagnosed with Zika virus in the past 6 months? | No |
| Have you travelled to an area with Zika virus transmission? | No |
| Alcoholism | No |
| Drug addiction | No |
| Alzheimer's disease / dementia before age 60 | No |
| Aneurysm | No |
| Fear / panic attacks | No |
| Attention deficit / hyperactivity disorder | No |
| Autism or Asperger's syndrome | No |
| Bipolar disorder | No |
| Blood coagulation disorders / hemophilia | No |
| Blindness before the age of 50 | No |
| Brain tumor / abnormality | No |
| Breast cancer | No |
| Cerebral palsy | No |
| Non-union of the lip or palate | No |
| Colorectal cancer | No |
| Flat feet | No |
| Depression | No |
| Epilepsy or seizures | No |
| Extra or fused fingers or toes | No |
| Genetic disorders | No |
| Hearing disorders / deafness under the age of 50 | No |
| Heart attack before age 50 | No |
| Heart defect | No |
| Huntington's disease | No |
| Immune disorders | No |
| Kidney defect / disorder / cancer | No |
| Intellectual disability / developmental delay | No |
| Melanoma | No |
| Mental retardation | No |
| Obsessive-compulsive disorder | No |
| Ovarian cancer | No |
| Pancreatic cancer | No |
| Parkinson's disease before the age of 60 | No |
| Pituitary disorder | No |
| Prostate cancer before the age of 50 | No |
| Schizophrenia | No |
| Speech disorders / lisping / stuttering | No |
| Split spine | No |
| Stroke under the age of 50 | No |
| Uterine cancer | No |
| Tourette syndrome | No |
| Vision disorders | No |
| Vitiligo / pigmentation disorders | No |
| Death before the age of 50, including childhood | No |
| Other cancer diagnoses before the age of 50 | No |
| Other congenital defects | No |
| Other health disorders | No |
| Diabetes | No |
| Hypertension | No |
| Rheumatoid arthritis | No |
| Pathology of the thyroid gland | No |
| Endometriosis | No |
“Big Five” personality traits of the Donor
1
Extraversion
2
Emotionality
3
Openness to New Experiences
4
Conscientiousness
5
Agreeableness
A
Psychological assessment of the donor:
The donor believes that the donation program is a wonderful opportunity to be useful to people, to help those who are waiting for this help. She will be pleased to understand that thanks to her, children will appear in this world, that someone will become parents, will fulfill her dream.
The donor is divorced, raising an 8-year-old daughter. The daughter goes to school, studies well. She is her “golden child” - she is well-mannered, calm, kind, not capricious. The daughter always makes contact, communicates, anyone can find a compromise, come to an agreement with her. She is an inquisitive, energetic and sociable child. She talks about her daughter with a smile and love.
The donor herself was also a non-conflict, balanced, obedient child. She was more vulnerable, sensitive in childhood. Now she knows how to better “hold the blows of fate with dignity”. She needed time to get closer to new people, for more open communication. She studied well, more inclined to the humanities. She loved to draw. Her favorite activity was walking with her friend in nature.
Grandmother is the closest person to her since she was a little girl. She was there most of the time, helped, supported, and raised her. Grandmother became a model of love, tenderness, warmth, and care for her. Grandmother taught her kindness, sincerity, and mutual assistance to people. And now grandmother is there, supports, and helps take care of her daughter, for example, when needed. The donor is also a support and reliable support for grandmother. She takes care of her, helps with treatment, and in any everyday situations.
After graduating from school, she entered college. A more independent life began - a student dormitory, new acquaintances, a new place to live, the need to grow up, become even more responsible. Studying was interesting, she liked specialized subjects, especially practical classes. As a result, she received a secondary specialized education, specializing in a pastry chef. Now she works as a seller-cashier in a supermarket.
She considers it her achievement that she is raising her daughter herself, that she is doing everything possible for her better future. That despite the difficult circumstances in life, she moves forward, does not give up and believes in the best.
Her peculiarity is her perseverance and conscientiousness in fulfilling the obligations she has undertaken. She is a reliable person and is always ready to come to the aid of loved ones.
She dreams of a happy childhood for her daughter, as well as her promising and better future. She wants to give her child a good education, opportunities and prospects.
The donor is usually collected, serious, quite laconic and restrained in conversation. She is a balanced, purposeful, strong-willed, persistent and responsible person.
