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 great opportunity to be useful to people, to help those who are waiting for it. She is pleased to think that thanks to her, someone will become parents, fulfill their dream, and have children. Also, the result of the program is a pleasant bonus for her - a financial reward that she can spend on useful and pleasant things for her own children.
The donor is married, has a son who is 6 years old and a daughter who is two years old. Her family is the most valuable thing in her life, it is her love and support. This is a place where she always wants to return. Her children are healthy, energetic, active, inquisitive. They are sociable, kind, friendly. They develop according to their age, love to play with their peers and learn everything new around them.
The donor also talks about her parental family with warmth and love. That she comes from an ordinary, good family, where there is respect, love and support.
The donor recalls her childhood as happy and cheerful. She was an active and energetic child. Open, kind, sociable. She was responsible and conscientious about her studies. She studied well, was interested in geography and biology. She attended various handicraft clubs and was fond of creativity. She had a good memory and imagination, liked to fantasize. She loved to spend her free time with friends playing games and chatting. She and her family would relax in nature, walk in the park, and watch comedy films.
After school, she entered college, where her studies became brighter and more interesting. Student life, more freedom, independence. Also new friends, experienced teachers, interesting practical classes.
After studying, she started working, had an active social life. She met her husband, they started a family, a son was born, and a few years later a daughter. She works, earns enough and has ambitions and goals. She strives for self-realization, development, and improvement. Her hobbies include constant development, learning new things, and reading books.
The donor currently works in a beauty salon. She has a secondary specialized education - Hairdresser-fashion designer. Her work is both a source of income and a favorite hobby for her.
She considers it her achievement that she was able to combine her fulfillment as a mother, wife, and as a professional in her field. That she always tries to find a balance between time, attention to her family, and self-realization in her profession.
Her special feature is her perseverance and conscientiousness in fulfilling her obligations. She is a reliable person and is always ready to help loved ones.
She dreams of a happy childhood for her children, as well as a promising and better future for everyone. She wants to give her children a good education.
She is purposeful, persistent, always goes towards her own goal. Sociable, knows how to make decisions independently and solve problems and situations. Self-confident, emotional, shows organizational qualities.
