Medical Information:

Do you have any allergies? If yes, please describe.

No, I do not have any allergies.

Please list any surgeries you have had (including oral):

I haven’t had any.

Have you ever been vaccinated for COVID-19? If yes, how many doses and when.

Twice and one booster.

Do you currently have any other medical condition that you are seeking treatment for? If yes, please describe:

N/A

Have you ever been diagnosed with a mental health disorder or sought treatment for mental health support? If yes, please describe.

N/A

What prescribed medications are you currently taking? (Please indicate dosage):

Citalopram

What prescribed medications have you taken in the past? (Please indicate dosage):

Antibiotics and birth control.

What form of birth control are you currently using?

N/A

Please describe your diet:

Healthy.

Do you have any dietary restrictions? If yes, what are they?

No

Do you exercise regularly?

Yes

Please list any STI/STDs you have had:

No

Have you ever had a major x-ray or other radiation exposure?

No

Have you ever been refused as a blood donor?

Yes, due to low iron.

Are there any immediate family medical concerns to be aware of?

No

Have there been any genetic disorders or congenital disabilities in your family?

No

Do you have any chronic illnesses or diagnosis? If so, please describe.

N/A

Have you ever been hospitalized? If so, please explain.

No

Do you have regular periods?

Yes

Have you had a PAP smear in the last 12 months? Was your PAP smear within normal limits?

No

Have you ever gone through any fertility treatments for yourself or as a potential surrogate/egg donor? If yes, please describe.

No

Have you been an egg donor before?

No

Please list pregnancies, including miscarriages and terminations.

Do you smoke? If yes, how often?

No.

Do you vape? If so, how often?

No.

Do you use marijuana? If yes, how often? What do you currently use?

No.

Do you consume alcoholic beverages? If yes, how often?

Socially.

Do you use illegal drugs? If yes, what type and how often?

No.

Family Medical History

Why do you want to be an egg donor?

I would love to give deserving people the chance to become parents - infertility is unfair.

Please explain how you think being a donor works.

Find a match, do some testing, take the meds, get the eggs!

What kind of communication, if any, would you like with the Intended Parent(s) during the process?

Yes, I would like to communicate! I would love to watch their journey.

What kind of communication, if any, would you like with the Intended Parent(s) after the process?

Some updates, maybe photos.

What would you like the Intended Parents to tell their child about you?

That my children and I both have huge hearts!

Is there anything you would want the Intended Parent(s) to know?

If the child requests to meet you, how will you feel?

I’m fine with that!

What are your main goals in life?

Travel! I have a career and a family, so now I would like to see the world!

What do you do for self care? (massage, Reiki, read a book, family time, walk in nature, etc.)

I like to do pilates and yoga, go for massages, take the dog for walks and spend time with friends.

What are your interests? Hobbies?

Spending time with my family and friends.

What are your favourite foods/snacks/drinks?

I’m a sweet girl rather than savoury. I like Mini Eggs and Skor bars. For meals I like Chicken Parmigiana and Steak. I’m not picky but I do not enjoy seafood.

What are your favourite restaurants/coffee shops?

Jack Astors, The Keg, Starbucks and Boston Pizza.

What are your favourite stores?

Lululemon, American Eagle and Gap.

What are your favourite sports?

In my younger days I enjoyed soccer, track and cheerleading! Now I like to watch my kids play sports and I like to do Pilates and Yoga.

What is your favourite colour?

Pink

Please describe your personality:

Funny, kind and hard-working.

Do you have any special talents?

What languages do you speak?

English and basic French.

Are you extroverted or introverted?

It depends one the crowd!

Are you shy or outgoing?

In between.

What are your Math Skills like?

Moderate.

Mechanical Skills?

Minimal.

Athletic Skills?

Moderate.

Artistic Skills?

Moderate.

What kind of interests do your children have?

Hockey, ball hockey being outside, video games, gymnastics, dancing and animals!