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 donation is a good deed in which she participates so that another family can become parents. She is a mother, so she understands how difficult it is when you don’t have the opportunity to have a child.
The donor is married, she and her husband have known each other since school, this is her “first love”. After school and university, they met again and decided to start a family. They have a good, trusting, mutually supportive relationship. In general, they have a positive, cheerful family, they appreciate each other and have common views on life values. The donor has a 6-year-old son who is active, sociable, open, brave, talkative and persistent.
The donor’s mother raised her and her brother alone. The main memories of her mother are that she worked hard to provide her and her brother with a decent life. Every summer, her mother went to work at children’s camps so that she and her brother could also be there and relax. The donor's mother is a positive, open-minded, sociable person with a good sense of humor, humorous and cheerful. She is kind, loving and caring.
Donor was balanced and non-conflict in her childhood. She took an active part in the social life of the school - concerts, competitions, sports competitions. Donor attended a theater club, did gymnastics and acrobatics. She is a creative, athletic, artistic child. She loved to be the first in everything, sought to be the center of attention. She likes to express herself, is not afraid to be in public.
She studied excellently. Her favorite subjects were geography, literature, biology. She loved to spend her free time with friends in interesting communication, active games, as well as visiting clubs, participating in amateur performances, etc.
After graduating from school, she entered the university, she chose the direction of study according to her own vocation and hobbies. Student life was interesting because it was filled with studying specialized subjects. But at the same time, it required greater independence and responsibility. She began to provide for herself, working in parallel with her studies.
The donor has a higher education - Speech therapist-defectologist. She currently works as a speech therapist.
Her special feature is determination. She believes that one should enjoy life to the fullest. She maintains her own blog on a social network. First of all, it is important for her how she feels, what she considers necessary for herself.
Her achievements today are primarily that she is a good mother, and also a true professional at work.
The material dream is to buy her own car. And from the mental one, it is a promising, happy, peaceful and calm future for herself, for her family, for her country.
Donor is a strong-willed and strong-spirited person, it is not inherent in her to lose hope, she quickly begins to think, act, look for ways to solve the situation. In any circumstances, she feels quite comfortable, knows how to adapt to the situation.
She is emotional, sensitive, open, courageous. Confident in her own abilities, persistent in the decisions she makes, has demonstrated leadership and organizational qualities.
Donor is sweet, pleasant to communicate with, talkative, charming. She has a good sense of humor, a positive outlook, and is optimistic. She is creative, talented, and develops her skills. Responsible, punctual, goal-oriented and ambitious.
