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 possibility of donation a long time ago. She knows from friends stories when a couple cannot get pregnant, how difficult it is to go through such an experience. Therefore, she decided to contribute to helping such people. And when she had a child, she became a mother, she decided that it was time to take part in the donation program.
The donor is divorced. She has a 3-year-old son, who is a sociable, active boy. He likes to count, learns letters, and enjoys reading books.
The donor's mother lives with a new family abroad. The father also has another family abroad. Everyone is friendly and communicates with each other. She has a large family - she has 2 brothers and a sister.
Her mother gave birth to her at the age of 17, while she was still studying. Therefore, as a child, the donor was raised by her grandparents. She grew up in the village, where it was fun, cozy, and warm. As a child, she was obedient, well-mannered, and silent. She always helped and protected her brother, who was 3 years younger. She is kind, responsible, and balanced. We had a big family, so it was fun and friendly. She studied well, had a greater inclination towards mathematical sciences. She was engaged in drawing, participated in competitions. She attended an embroidery and modeling club, and loved any kind of needlework. She was shy and quiet. When she grew up, she became more open, direct, and sociable.
After the 9th grade, she entered college. She was a responsible, conscientious, hardworking student. She started working in her second year, striving for financial independence.
She has a secondary education - Administration and dispatching communications of the railway. Then she received a higher economic education - Management.
Today, the donor has been working in a bank for more than 10 years. She works in the consumer credit department. She likes to work with people, help them, be useful. She is pleased to see the result of her work, customer satisfaction.
Family for the donor is primarily mutual understanding and warm feelings.
Her achievements are her development, her step-by-step decisions that brought her to where she is. She understands that she set the right goals.
Her specialty is that she understands people, knows how to sympathize, show empathy.
She dreams of different things, and of many things... for example, she dreams of vacationing on the islands with her family. She dreams of financial stability, peace of mind and a promising future.
Her grandmother says that she has a talent for helping people. Her loved ones see her as friendly, reliable, they are confident in her.
Donor is a kind, open-minded person, always feels sorry for everyone, wants to help, understand. She is responsible, conscientious, smart, prudent, intelligent. She is kind, sincere, responsive in communication, pleasant, friendly. Punctuality, accuracy, and conscientiousness are important to her. Non-conflict, sociable and empathetic.
