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:
Donor has heard stories from her clients more than once about what women feel when they cannot get pregnant and give birth to a child. Therefore, if she has the opportunity to help such women in some way, why not. Donation is a good deed, it is help and benefit for others.
Donor is married, she and her husband are raising two daughters – 7 and 2 years old. The younger daughter is active, energetic, combative. The older one is more balanced, she is friendly, sociable, sensual. She and her husband studied together, started dating, then got married, they have been together for 12 years.
Now she and her husband are developing a small business aimed at helping people – they buy products and deliver them to villages in the Kharkiv region. She also earns money by doing eyelash extensions. Donor works as a teacher at an agronomic college, currently on maternity leave. In general, she likes working with students. She has higher education - in agronomy and pedagogy.
The donor's mother is now retired, she was an accountant. Her father died when she was 12 years old. She had heart problems. The donor has 4 older brothers, who have their own families and children. Therefore, they have a very large, friendly and cheerful family. Her mother worked a lot, plus she ran a large farm. After her father's death, she and her brothers helped her mother - they worked on the farm, cooked, cleaned, etc. Therefore, the donor was hardworking, responsible, and conscientious from childhood. She was a calm, kind, friendly child. She had a wide circle of friends and acquaintances with similar interests. The donor was always fascinated by communicating with cultural and educated people. Since childhood, she was engaged in music and vocals. Therefore, she is currently working as an artistic director at an agricultural college. The donor studied well, she easily and interestingly mastered biology and mathematics. She is interested in literature. She had an active student life - various performances, contests, competitions. After the 9th grade, the donor entered college, where it was more interesting to study than at school, and there was also an additional incentive to study well - an increased scholarship for excellence.
The donor says about her mother that she was strict and disciplined in their childhood. But she is kind, she will always hug, support, listen, and understand. And now the donor receives support and trusting conversation from her mother. Her mother was in a boarding school as a child, this had its impact, she was taught discipline, but now she is softer, has a warm, close relationship with the donor.
Dad was kind, never offended, played, called the donor "flower". He was hardworking, capable, persistent. The donor has warm memories and misses him. This is a great loss for her and the whole family.
Family for her is a solid foundation of life, it is support, it is a place where you are always welcome.
As for friendship, for the donor, her closest friends are her brothers, with whom she grew up since childhood. She also has 2 close friends. Others are acquaintances or colleagues for her. The donor is trusting, naive, and friendly, so sometimes some people can take advantage of this.
Donor dreams of traveling to Transcarpathia with her family. She especially wants her mother to go with them. Mom worked hard all her life to raise them, she really wants to thank her mother, do something nice for her, give her the opportunity to relax and enjoy the journey - to see, feel and rejoice.
Donor encourages her children to learn English so that they can easily travel and see the world later.
Her greatest achievement is the birth of daughters, she always dreamed of becoming a mother of girls. They get along well, have warm, friendly relations, she wants them to support each other in the future, they are family people.
Donor is pleasant, slim, dark-haired. She is polite and intelligent, responsible and conscientious, creative and artistic, balanced and friendly. She is versatile, has an interest in different areas, strives for self-development and self-realization.
