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's nice to think that other people will feel what parenthood is thanks to her. Someone will also have sincere and kind children like hers, she will be able to make someone happy.
The donor has a 4-year-old daughter who is a sociable, open, communicative girl. She does dancing, gymnastics, loves to perform, be the center of attention.
The donor's father is a builder, he provides for the family, helps everyone, protects. He is kind, balanced, never raises his voice. He will calmly come to the aid of loved ones, and first solve their problems, then only take care of himself.
The donor's mother, on the contrary, is emotional, strong-willed, seeks to take control of the family into her own hands. She is strict, demanding, but fair and loving.
The donor was active, mobile, strong-willed as a child, because her circle of friends was mostly boys. She defended weaker children at school who were being bullied by bad boys. She could not stay away from injustice and unfair treatment.
Since the 6th grade of school, the donor wanted to become a soldier, she was engaged in the Patriot club, where she made progress, was the leader of the team with which they participated in competitions, took prizes. She studied well, was fond of history, biology. She loves to read books, is interested in literature, studied English in depth. For 7 years she was engaged in karate, dancing, gymnastics. Sports still occupy an “honorable” place in her life.
After graduating from school, she entered the university, where she received a higher law degree. She was fond of criminology, wanted to become an investigator. But everything changed when her husband died in the war two years ago, he was a soldier.
She entered the university to get a second higher education - Psychology. She has experience of loss, so she wants to learn how to help others in such moments. She wants to learn how to correctly, without traumatizing, explain her father’s death to her own child. She wants to help military families, and thanks to her experience, she can understand them more deeply.
She completed a first aid course during the war.
Her specialty is the ability to hide her own pain behind a smile so as not to upset others. She is sociable, the "soul of the company", always ready to come to the aid of loved ones and at the expense of herself.
She is proud of herself that, despite the pain of loss, she continues to raise her daughter, to finish building a house that she and her husband started to build together.
She dreams of financial stability and independence in order to be able to provide for her child's future.
She is energetic, kind, sincere, open, genuine and sociable. Donor is fair, loves to travel, easy to communicate, but sensitive to insults. She does not tolerate hypocrisy, it is better for her to tell the truth to her face. She knows how to stand up for herself, defend her own opinion.
Donor is responsible, punctual, accurate in business. Purposeful, ambitious, hardworking. She is self-reliant, independent, strong-willed, positive, and well-mannered.
