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 learned about the donation program from social advertising, became interested and decided why not become a donor and help people who dream of becoming parents. Her husband supported her in this, she decided to take part in the program.
The donor has been with her husband for 10 years, of which 5 years have been married. They have a 3-year-old daughter. She talks about her with love and admiration that she is an inquisitive, smart, creative, talented girl - she dances, draws. Her daughter got her passion for drawing from her. She studied at an art school for 6 years, she can draw well.
The donor's parents have been together for 28 years, for her this is a model of healthy, strong relationships. They have five children. They all stick together, support each other.
Dad is a decorator-artist, one of the best in the country. He has awards and state distinctions. Talented, sensual, emotional, open and sincere.
Mom is the organizer, she organizes all the financial and technical side of her father's work. She knows how to calculate everything, plan and control the process. She is a calm, non-conflict, responsible person.
Donor jokes that she is a mix of her parents' qualities. She was an obedient, well-mannered child. She studied well, had a greater inclination towards humanitarian subjects - literature and creativity were her favorites. She had artistic talent since childhood, studied at an art school. Noisy, large companies are not for her, her free time is visiting clubs, drawing. She took an active part in school life - amateur performances, competitions, organizing events.
After the 11th grade, she hesitated what to choose to continue her studies. She was interested in journalism or military affairs.
She entered the Aviation University, but left it after a year of study. Since studying was expensive for her, she had already married at that time and worked to provide for her family together with her husband.
She graduated from makeup artist courses and works in this field with pleasure. This gives her the opportunity to realize her artistic talent and aesthetic taste. Aims to develop further, improve skills, knowledge, abilities.
She considers her own family to be her main achievement. Since her youth, she has dreamed of a happy family in which relationships are built on love, respect, trust, and partnership. It is important for her that her child grows up and sees loving, happy parents together. She considers her family to be just that.
She considers her speciality to be creative talent – whatever she sets her mind to, she will succeed. She easily learns new things, has a well-developed imagination and artistic talent.
Her dream is to create her own business, namely, to open a small cozy retro-style cafe with a children's corner, for relaxing with her family.
Donor shows herself as a responsible, punctual, persistent, hardworking person. She is independent, purposeful, goes towards her goal, has ambitions. She is kind, positive, always ready to help people, understand their feelings, empathize. At the same time, she is modest, balanced, well-mannered, pleasant to communicate with, and friendly.
