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 donation is a charitable and good deed. It is important for her to be useful, to help others. Also, during the program, there is an opportunity to get a comprehensive health examination, which is a bonus for her. And to receive financial compensation, which is support for her family.
The donor is married, her husband is a military man. They are raising a daughter who is now 2.5 years old. She is an energetic, active, demanding girl. But she is kind, cheerful, inquisitive and developed. The donor plans to adapt her daughter to kindergarten and look for a new job. She is currently on maternity leave.
The donor's parents divorced when she was a child. Her father died. She has a stepfather, who is also now a military man. The donor has a 16-year-old brother and a 6-year-old sister. They have a large, strong, loving family, where the main thing is support, understanding, and mutual assistance.
The donor is very similar to her mother, who is a person with a strong character, combative, strong-willed, but she is also friendly, cheerful, emotional, and positive.
Donor was the first child, expected, loved. Mom always understood, heard, helped her. Supported all her undertakings, believed in her. Donor studied well, with ease and interest she mastered literature, language, biology, music. She was engaged in dancing. She graduated from music school. She played in an orchestra of folk musical instruments. She and the team often attended various performances, concerts, competitions, took prizes. She was a sociable, open child. She was responsible, conscientious, persistent in her studies. She helped her mother, especially when her younger sister was born. Donor helped her mother with the younger ones, and with the housework.
After school, she entered the university. During her studies there, she took a military department, where she met her husband - he was her classmate at the military department. It is not easy to live with a military husband, she also has to be strong in spirit, ready for different situations, be hardy, patient and independent.
The donor has a higher education - Psychologist. So far she has no work experience, but she would like to work with children. She plans to start working and develop soon. She strives for career growth, self-realization, improvement.
Her hobbies are sewing, beadwork. Also in her free time, they like to sing and dance with her daughter.
Her special feature is that she is patient and enduring, can understand, endure, and achieve a lot.
She dreams of the end of the war, of peace, of tranquility, of a happy future.
As the oldest child in the family, she must always be the first, be an example, be a support for the younger ones. She also helps her mother, they have close and friendly relations.
Donor is pleasant, polite, friendly in communication. She is smiling, positive, optimistic. A “fighter”, young, but smart and prudent. She is purposeful, persistent, diligent. Punctuality, accuracy, intelligence are characteristic of her. Donor is an emotional, sensitive, sincere and humorous person.
