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6012024_1

&

6012024_2

DONOR 1

Fullname

6012024_1

Country

United States

Address

Eye Color

Blue

Hair Color

Light Brown

Height

5’2”

Ethnicity

White/Caucasian

Education

Bachelor’s degree

Hobbies

Cooking, Gardening, Listening to music, Photography, Playing sports, Taking care of animals

Anything else would you like to mention about your family medical history to the
Adoptive parent

Anything else would you like to mention about your talents,skills,interests 

2nd degree black belt in Kempo
All American Gymnast at a division 1 university

DONOR 2

Fullname

6012024_2

Country

United States

Address

Eye Color

Hazel

Hair Color

Grey

Height

6'1"

Ethnicity

White/Caucasian

Education

Some college

Hobbies

Hunting, Listening to music, Working out/exercising, Drawing/painting, Camping, Fishing, Playing an instrument

Anything else would you like to mention about your family medical history to the
Adoptive parent

2nd degree black belt in Kempo

Anything else would you like to mention about your talents,skills,interests 

BASIC INORMATION

Full name

6012024_1

6012024_2

Country

United States

United States

Address

Eye color

Blue

Hazel

Hair color

Light Brown

Grey

Height

5’2”

6'1"

Ethnicity

White/Caucasian

White/Caucasian

Education

Bachelor’s degree

Some college

Hobbies

Cooking, Gardening, Listening to music, Photography, Playing sports, Taking care of animals

Hunting, Listening to music, Working out/exercising, Drawing/painting, Camping, Fishing, Playing an instrument

Anything else would you like to mention about your talents, skills, interests

2nd degree black belt in Kempo
All American Gymnast at a division 1 university

2nd degree black belt in Kempo

Anything else would you like to mention about your family medical history to the
adoptive parent

Photos

PHOTOS

EMBRYO

How many embryos do you wish to donate

What are the grades of the embryos?

1

2ab

Have the embryos been genetically tested

Yes

Do you know the gender of the embryos

girl

Have the embryos from this batch resulted in a life birth

Age of embryos when they were frozen

Yes

Not sure

How long ago the embryos were created

Genetic mother’s age at the egg retrieval

Less than 10 years ago

Less than 40 years old

Have the embryos from this batch been already donated to another adoptive parent

No

Embryo

MEDICAL HISTORY

DONOR 1

DONOR 2

Allergy

Donor's parent

Donor

Alzheimer

Anxiety

Asthma

Donor

Autism

Bipolar disorder

Cancer

Celiac disease

Cystic fibrosis

Depression

Donor's parent

Diabetes

Donor, Donor's parent

Epilepsy

Fibromyalgia

Fragile X syndrome

Heart conditions

Donor's grandparent

Hemochromatosis

High blood pressure

Donor's parent

Huntington’s disease

Lupus

Marfan syndrome

Multiple sclerosis

Obesity

Phenylketonuria

Polycystic kidney disease

Rheumatoid arthritis

Schizophrenia

Stroke

Substance abuse

Tay-Sachs disease

Medical Histroy

DONOR 1

Allergy

Donor's parent

Alzheimer

Anxiety

Asthma

Autism

Bipolar disorder

Cancer

Celiac disease

Cystic fibrosis

Depression

Donor's parent

Diabetes

Epilepsy

Fibromyalgia

Fragile X syndrome

Heart conditions

Donor's grandparent

Hemochromatosis

High blood pressure

Donor's parent

Huntington’s disease

Lupus

Marfan syndrome

Multiple sclerosis

Obesity

Phenylketonuria

Polycystic kidney disease

Rheumatoid arthritis

Schizophrenia

Stroke

Substance abuse

DONOR 2

allergy

Donor

alzheimer

anxiety

asthma 

Donor

autism

bipolar disoder

cancer

celiac disease

cystic fibrosis

depression

diabetes

Donor, Donor's parent

epilepsy

fibromyalgia

fragile x syndrome

heart conditions

hemochromatosis

high blood pressure

huntington's disease

lupus

marfan syndrome

multiple sclerosis

obesity

phenylketonuria

polycystic kidney disease

rheumatoid arthritis

schizophrenia

stroke

substance abuse

Information on egg/sperm donor

Letter