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 thanks to her, other people will feel what parenthood is. Someone will also have sincere and kind children like hers, she will be able to make someone happy.
The donor is married. She has a 10-year-old son who is fond of football and fishing. He is athletic, active, energetic, but at the same time gentle, kind, and respects his elders.
The donor has warm and friendly relations with his parents. His mother is a primary school teacher, an emotional, vulnerable, sensual person. For the donor, she is always caring, loving, and gentle.
His father, as far as the donor can remember, held leadership positions. He is a generous, caring person, he is a support and protection for his family. He is decisive, reliable, and balanced. The donor is a "daddy's daughter", in any crisis situation the first person she will call for support is her father.
The donor's older brother is a military man, commander of a mechanized brigade.
The donor was polite and obedient in her childhood. Her warmest memories are of vacationing at sea with her parents and brother, whom she looked forward to every summer. She studied well, she was most fond of biology, probably because she liked the teacher. She danced, she is plastic, artistic, has a sense of rhythm. Now she also continues to attend dance classes. In her free time, she was surrounded by friends, walks in nature, active, outdoor games.
After school, she continued her studies at the Technical School of Food Technologies. Where she received secondary education, junior specialist, specialization Production of sugar products.
At first, after studying, she worked in production in her specialty. After maternity leave, she changed her direction of activity.
Now she works as an accountant in the spare parts department of an agricultural company.
Her special feature is her love of cleanliness and order. She believes that everything should be in its place.
She considers her recent purchase of a car, which she has long dreamed of, to be her achievement.
Most of all, she dreams of her brother returning from the war as soon as possible. She thinks about it every day. Everything else is plans and goals that can be implemented.
Those close to her believe that she is energetic, kind, sincere, open, genuine and sociable. She agrees with this, adding about herself that she is fair, loves to travel, easy to communicate with. She knows how to stand up for herself, defend her own opinion.
Donor is responsible, punctual, accurate in business. Purposeful, ambitious, hardworking. She is independent, self-reliant, strong-willed, but at the same time kind, sincere, and open. Positive, with a sense of humor, and an optimist.
