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:
She has a pragmatic and practical attitude towards her own participation in the donation program. She believes that this is a program where two women can “exchange” what each of them needs at the moment. The donor can share her cells, and in return receive material assistance for her family.
The donor is married, has two daughters – 7 and 5 years old. Her girls are active, creative, inquisitive and smart. The older one goes to school, is more calm and assiduous. The younger one goes to kindergarten, is more energetic, sociable, strong-willed. They like to draw, make applications, crafts, learn something new.
The donor’s parents are always there, ready to support and help. The mother often helps take care of the children so that she can work.
For the donor, the mother is both a close friend, an authority, and an example. They have a warm, close relationship. The mother is kind, gentle, caring. She knows how to listen, support, and is always ready to help.
The father is a reliable support, it is strength, will, and perseverance. He will solve the problem, protect, and take care of.
The donor was a calm, well-mannered, problem-free child. She studied well, was creative - drew, sang. Mathematical sciences were more difficult for her, she was more interested in art, music, and creativity. She drew posters, playbills for school events. She often participated in various performances and concerts. She fondly recalls how she and her family had dinner together almost every evening, talked, and played various board games. They went to the movies together, went for walks in nature, went fishing, visited friends, picked mushrooms, and went to the mountains. They still spend weekends together - family holidays, picnics, walks, etc. It's better to spend time in comfort, peace with family than noisy companies, crowds.
After the 9th grade, the donor entered a vocational lyceum, where the study was more interesting, the teachers presented information differently, practical classes, new friends, interesting communication, common interests, friendly student life. She received a secondary specialized education - construction.
In the 2nd year, she met her husband, they met, got married, their first daughter was born, and then a second. They have an ordinary, friendly, strong family. They like to spend time together walking in nature, in the park, cook dinner together, communicate, watch movies.
The donor works as a cashier in a cafe, and also works part-time as a manicurist.
The biggest achievement for the donor today is buying her own apartment with her husband, for their family.
She considers her speciality to be the ability to establish contact and communication with almost every person, despite the fact that she is rather an introvert. But she's quite sociable and friendly.
Her main dream is to travel, see the world, different countries and cultures and show this world to her daughters.
Relatives describe the donor as a calm, balanced, kind and empathetic person. During communication, she leaves a pleasant impression. She is a little shy, but quite open, sociable. She's responsible, punctual, hardworking, persistent and purposeful.
