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DONOR 1
Fullname
Jordan Holloman
Country
United States
Address
1101 W Sterling Dr.
Eye Color
Hazel
Hair Color
Dark Brown
Height
6’0”
Ethnicity
White/Caucasian
Education
Graduate degree
Hobbies
Camping, Cooking, Drawing/painting, Eating, Hiking, Listening to music, Keeping pets, Playing an instrument, Visiting with friends, Woodworking
Anything else would you like to mention about your family medical history to the
Adoptive parent
Allergies: Donor and donor's father experience mild hay fever; donor has mild allergy to cats
Cancer: Both parents of donor have been treated for melanoma; donor's paternal grandmother passed away from aggressive soft tissue sarcoma.
Obesity: Donor's mother and sister have struggled with maintaining a healthy weight
Heart Conditions: Donor's maternal grandmother experienced a more than one heart attack (likely caused by lifestyle choices--i.e., poor diet, lack of exercise, etc.)
Diabetes: Donor's maternal grandmother was treated for minor Type II diabetes (likely caused by lifestyle choices--i.e., poor diet, lack of exercise, etc.)
Anything else would you like to mention about your talents,skills,interests
DONOR 2
Fullname
Country
Address
Eye Color
Hair Color
Height
Ethnicity
Education
Hobbies
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
These records should be obtained from Utah Fertility Clinic as we were paired with an egg donor through them.
BASIC INORMATION
Full name
Jordan Holloman
Country
United States
Address
1101 W Sterling Dr.
Eye color
Hazel
Hair color
Dark Brown
Height
6’0”
Ethnicity
White/Caucasian
Education
Graduate degree
Hobbies
Camping, Cooking, Drawing/painting, Eating, Hiking, Listening to music, Keeping pets, Playing an instrument, Visiting with friends, Woodworking
Anything else would you like to mention about your talents, skills, interests
Anything else would you like to mention about your family medical history to the
adoptive parent
Allergies: Donor and donor's father experience mild hay fever; donor has mild allergy to cats
Cancer: Both parents of donor have been treated for melanoma; donor's paternal grandmother passed away from aggressive soft tissue sarcoma.
Obesity: Donor's mother and sister have struggled with maintaining a healthy weight
Heart Conditions: Donor's maternal grandmother experienced a more than one heart attack (likely caused by lifestyle choices--i.e., poor diet, lack of exercise, etc.)
Diabetes: Donor's maternal grandmother was treated for minor Type II diabetes (likely caused by lifestyle choices--i.e., poor diet, lack of exercise, etc.)
These records should be obtained from Utah Fertility Clinic as we were paired with an egg donor through them.
Photos
PHOTOS
EMBRYO
How many embryos do you wish to donate
What are the grades of the embryos?
We have 6 total (4 are PGS-tested normal; we'd like to dispose of the 2 abnormal ones)
Female HBBA, Female HBBB, Female HBCB, Male HBBB
Have the embryos been genetically tested
Yes
Do you know the gender of the embryos
3 female, 1 male
Have the embryos from this batch resulted in a life birth
Age of embryos when they were frozen
Yes
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 30 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, Donor's parent
Alzheimer
Anxiety
Asthma
Autism
Bipolar disorder
Cancer
Donor's parent, Donor's grandparent
Celiac disease
Cystic fibrosis
Depression
Diabetes
Donor's grandparent
Epilepsy
Fibromyalgia
Fragile X syndrome
Heart conditions
Donor's grandparent
Hemochromatosis
High blood pressure
Huntington’s disease
Lupus
Marfan syndrome
Multiple sclerosis
Obesity
Donor's parent
Phenylketonuria
Polycystic kidney disease
Rheumatoid arthritis
Schizophrenia
Stroke
Substance abuse
Tay-Sachs disease
Medical Histroy
DONOR 1
Allergy
Donor, Donor's parent
Alzheimer
Anxiety
Asthma
Autism
Bipolar disorder
Cancer
Donor's parent, Donor's grandparent
Celiac disease
Cystic fibrosis
Depression
Diabetes
Donor's grandparent
Epilepsy
Fibromyalgia
Fragile X syndrome
Heart conditions
Donor's grandparent
Hemochromatosis
High blood pressure
Huntington’s disease
Lupus
Marfan syndrome
Multiple sclerosis
Obesity
Donor's parent
Phenylketonuria
Polycystic kidney disease
Rheumatoid arthritis
Schizophrenia
Stroke
Substance abuse
DONOR 2
allergy
alzheimer
anxiety
asthma
autism
bipolar disoder
cancer
celiac disease
cystic fibrosis
depression
diabetes
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
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