top of page

Amna Jamal

&

Micheal Harris

DONOR 1

Fullname

Amna Jamal

Country

Canada

Address

----------------

Eye Color

Green

Hair Color

Red/Auburn

Height

5.4

Ethnicity

Other

Sample

Education

Associates degree

Hobbies

Listening to music, Motocross, Hiking, Photography, Sewing/knitting, Using a computer, Playing video games, Playing sports, Playing an instrument, Gardening, Collecting things

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

Nothing

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

Dancing

DONOR 2

Fullname

Micheal Harris

Country

Canada

Address

---------------

Eye Color

Blue

Hair Color

Blond

Height

4.7

Ethnicity

Latino/Hispanic

Education

High school

Hobbies

Keeping pets, Being a leader of a group, Going to church/temple

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 

N/A

BASIC INORMATION

Full name

Amna Jamal

Micheal Harris

Country

Canada

Canada

Address

----------------

---------------

Eye color

Green

Blue

Hair color

Red/Auburn

Blond

Height

5.4

4.7

Ethnicity

Other

Sample

Latino/Hispanic

Education

Associates degree

High school

Hobbies

Listening to music, Motocross, Hiking, Photography, Sewing/knitting, Using a computer, Playing video games, Playing sports, Playing an instrument, Gardening, Collecting things

Keeping pets, Being a leader of a group, Going to church/temple

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

Nothing

N/A

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

Dancing

Photos

PHOTOS

EMBRYO

How many embryos do you wish to donate

What are the grades of the embryos?

2

----

Have the embryos been genetically tested

Yes

Do you know the gender of the embryos

Yes

Have the embryos from this batch resulted in a life birth

Age of embryos when they were frozen

5-7 days

How long ago the embryos were created

Genetic mother’s age at the egg retrieval

Less than 5 years ago

Less than 25 years old

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

Yes

Embryo

MEDICAL HISTORY

DONOR 1

DONOR 2

Allergy

Donor

Donor child

Alzheimer

your parent, your grandparent

Anxiety

your parent

Asthma

your parent

You

Autism

your child

Bipolar disorder

your grandparent

Cancer

Celiac disease

Cystic fibrosis

Depression

your parent

Diabetes

Donor child

your grandparent

Epilepsy

Donor

Fibromyalgia

Donor

Fragile X syndrome

Donor child

Heart conditions

Donor's grandparent

Hemochromatosis

Donor child, Donor's parent

High blood pressure

Huntington’s disease

Donor's grandparent

Lupus

Donor child

Marfan syndrome

Donor

Multiple sclerosis

Obesity

Phenylketonuria

Polycystic kidney disease

Rheumatoid arthritis

Schizophrenia

Stroke

Substance abuse

Tay-Sachs disease

Donor child, Donor's parent, Donor's grandparent

Medical Histroy

DONOR 1

Allergy

Donor

Alzheimer

your parent, your grandparent

Anxiety

your parent

Asthma

your parent

Autism

your child

Bipolar disorder

your grandparent

Cancer

Celiac disease

Cystic fibrosis

Depression

your parent

Diabetes

Donor child

Epilepsy

Donor

Fibromyalgia

Donor

Fragile X syndrome

Donor child

Heart conditions

Donor's grandparent

Hemochromatosis

Donor child, Donor's parent

High blood pressure

Huntington’s disease

Donor's grandparent

Lupus

Donor child

Marfan syndrome

Donor

Multiple sclerosis

Obesity

Phenylketonuria

Polycystic kidney disease

Rheumatoid arthritis

Schizophrenia

Stroke

Substance abuse

DONOR 2

allergy

Donor child

alzheimer

anxiety

asthma 

You

autism

bipolar disoder

cancer

celiac disease

cystic fibrosis

depression

diabetes

your grandparent

epilepsy

fibromyalgia

fragile x syndrome

heart conditions

hemochromatosis

high blood pressure

huntington's disease

your grandparent

lupus

Donor's parent

marfan syndrome

multiple sclerosis

obesity

phenylketonuria

polycystic kidney disease

your grandparent

rheumatoid arthritis

your grandparent

schizophrenia

stroke

substance abuse

Information on egg/sperm donor

Letter
bottom of page