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DONOR 1
Fullname
Molly Poulton
Country
USA
Address
1215 131st Court Northeast, Blaine, MN 55434
Eye Color
Brown
Hair Color
Dark Brown
Height
5' 4"
Ethnicity
White/Caucasian
Education
Bachelor’s degree
Hobbies
Beauty and hair care, Keeping pets, Visiting with friends, Watching TV or movies, Singing, Reading, Listening to music, Taking care of people
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
DONOR 2
Fullname
Bryce Poulton
Country
USA
Address
1215 131st Court Northeast, Blaine, MN 55434
Eye Color
Blue
Hair Color
Light Brown
Height
6' 0"
Ethnicity
White/Caucasian
Education
Associates degree
Hobbies
Cooking, Listening to music, Playing video games, Watching TV or movies, Working out/exercising, Visiting with friends, Using a computer, Reading
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
BASIC INORMATION
Full name
Molly Poulton
Bryce Poulton
Country
USA
USA
Address
1215 131st Court Northeast, Blaine, MN 55434
1215 131st Court Northeast, Blaine, MN 55434
Eye color
Brown
Blue
Hair color
Dark Brown
Light Brown
Height
5' 4"
6' 0"
Ethnicity
White/Caucasian
White/Caucasian
Education
Bachelor’s degree
Associates degree
Hobbies
Beauty and hair care, Keeping pets, Visiting with friends, Watching TV or movies, Singing, Reading, Listening to music, Taking care of people
Cooking, Listening to music, Playing video games, Watching TV or movies, Working out/exercising, Visiting with friends, Using a computer, Reading
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
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
No
Do you know the gender of the embryos
No
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 35 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
Alzheimer
Donor's parent
Anxiety
Donor
Asthma
Donor child
Donor child
Autism
Donor child
Donor child
Bipolar disorder
Cancer
Celiac disease
Cystic fibrosis
Depression
Diabetes
Epilepsy
Donor
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
Tay-Sachs disease
Medical Histroy
DONOR 1
Allergy
Donor
Alzheimer
Anxiety
Asthma
Donor child
Autism
Donor child
Bipolar disorder
Cancer
Celiac disease
Cystic fibrosis
Depression
Diabetes
Epilepsy
Donor
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
DONOR 2
allergy
alzheimer
Donor's parent
anxiety
Donor
asthma
Donor child
autism
Donor child
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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