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 people, if they have the opportunity, should be ready to help each other. It is nice to think that other people will become parents thanks to her. And for her, a pleasant bonus will be a financial reward.
The donor is married, has a son, who is now 9 years old. He is an interesting, inquisitive, open-minded boy. He likes to assemble a constructor, model. He is emotional, easily gets carried away by something new, knows how to entertain himself and play.
Although the donor's parents divorced 3 years ago, they have a calm, friendly relationship, and maintain communication.
The donor's mother is calmer and softer in character, not as impulsive and emotional as she is. Her mother has always been patient, caring, kind, gentle with her and her sister and taught them to be friendly, compassionate, and to help people. She works as a social worker.
The donor has the character of her father - with humor, strong-willed, purposeful, emotional. She is her father's daughter. She listened more to her father, they are closer in spirit. He is kind, reliable, courageous.
She has an older sister who already has her own family and 3 children. They have friendly, warm relationships in their family. Everyone trusts each other, helps, supports.
The donor was balanced in childhood, tried to be obedient, but was cunning - as the youngest in the family, she observed and drew conclusions. And now she often observes people to understand them, to draw conclusions for herself, to reflect, to think. She was engaged in dancing, sports. She took an active part in school life, in various competitions, performances. She studied piano at a music school. She wanted to try herself in many things, was interested in various things. She was purposeful and persistent in her studies. She was good at math. She grew up in a village, so she spent her free time with friends outside, in nature, on the river, in the forest, in the fresh air.
After the 11th grade, she entered a medical college, where her studies were interesting and exciting. Donor has a secondary medical education - a paramedic, an obstetrician. She also completed additional laboratory assistant courses and works as a laboratory assistant in a hospital.
Now her hobby is beadwork. It calms her down, gives her time to think inside herself.
Her special feature is her patience, hard work, and perseverance - if she decides on something, she will get it, she will reach her goal.
She dreamed of her own house, which they recently purchased, now she dreams of furnishing it beautifully and buying a car.
Her relatives believe that she is stubborn, if she decides on something, she will definitely do it. Sometimes she can immerse herself in her own thoughts and reflections, be by herself.
Donor is smart, judicious, quite pragmatic, purposeful and persistent. She is emotional, confident in her own abilities, strong-willed and active. She has a sense of humor. He has to look closely at unfamiliar people and learn more before he can trust them and behave more openly.
