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 always wanted to help others. She has good genetics, good health, good physical data, and can be useful to someone else with this. She believes that being a donor is like charity, it is a good deed.
The donor grew up with her mother, she raised her herself. Her mother is an emotional, sensitive, hot-tempered woman. But she is kind and quickly forgets the bad. She is very responsible and always brings everything she undertakes to the end. She is purposeful, persistent and strong in spirit. She is a caring and loving mother. She worked as a seamstress.
The donor has a sister who is 15 years older than her, with whom she has a warm, friendly, close relationship. They trust each other with their experiences and secrets.
The donor herself was an active child. She loved going to kindergarten, school. Sociable and friendly. She studied well, was interested in history and law. She grew up in a village, unfortunately there was no opportunity to attend clubs, but she always dreamed of dancing. Now she wants to make this dream come true.
As a child, she spent most of her time with her girlfriend and friends outdoors, playing with dolls or spending time actively.
After the 10th grade, she entered the lyceum to study as a pastry chef. There was an interesting and eventful student life, good teachers, new friends, and interesting practical classes. She received a secondary specialized education as a pastry chef. Now she works in a cafe, in the kitchen, in the hot department. She often makes cakes for holidays for her family, friends, and loved ones.
At the age of 18, she met her future husband in a common company of friends. They talked a lot, went for walks, then started dating, and got married. And now they have been together for 10 years.
Her greatest achievement to date is that she has learned to better manage her own emotions, has a good level of self-control, understands in which circumstances it is better to remain silent than to conflict. She is also a person with a sense of humor and optimism.
Her special feature is openness in communication, sociability, sociability. And the fact that she is persistent and purposeful in her plans.
She dreams of a more carefree and calm life, more ease in everyday life, joy and happiness for herself and her loved ones.
Her environment describes her as very hardworking, diligent and responsible. She is also a good "diplomat", can smooth out the conflict, come to an agreement, has a positive outlook on life.
She believes that she is naive sometimes, believes in the best in people, sincere, open. She is emotional, sensual, sensitive, but non-conflict. In communication, she is simple, easy, friendly and smiling.
