Other academic information: I am in my first semester of college right now, pursuing a degree in Liberal Arts.
Educational Goals: Finish college and receive my teaching credentials.
Occupational Information
Current Occupation: Sales, Student
Previous Occupation(s): Retail management
Career Goals: To become a teacher.
Personal Health Information
Blood Type:
General Health: Good
Hearing: Good
Diet: Good
Allergies: None
Do you wear contacts or glasses?
Yes, I am nearsighted.
Have you ever had braces? No
Have you ever had cosmetic facial surgery?
No
Please list any past or current medical problems: None
Have you ever had a problem with alcohol or substance abuse? No
Are you a smoker? No
Family Medical History
Medical Condition
Self
Family
Comments
Neurological
Cardiovascular
Blood
Respiratory
Gastrointestinal
Liver
Kidneys
Metabolic/endocrine
Skin
Bone
Senses
X
X
self, father, sister-corrective lenses
Allergies
Cancer
Substance abuse
Learning disability
Other
Psychological History
Have you or anyone in your immediate family ever been diagnosed with a major psychological or psychiatric disorder?(i.e. schizophrenia, bi-polar disorder, major depression) No
Have you or anyone in your immediate family ever been diagnosed with hyperactivity/ADD/ADHD? No
Genetic History
Have you or anyone in your immediate family ever been diagnosed with a birth defect? No
Have you or anyone in your immediate family ever been diagnosed with mental retardation? No
Have you or anyone in your immediate family ever been diagnosed with a genetic or chromosomal disorder? No
Reproductive History
Proven fertility: Yes
Have you or anyone in your immediate family ever been diagnosed with fertility problems? No
Have you or anyone in your immediate family ever suffered recurrent miscarriages and/or still births? No
Have you or anyone in your immediate family had multiple births (i.e. twins, triplets)? I have half-cousins who are twins.
Personal Profile
Describe your personality and character: Friendly, outgoing, optimistic, charming.
How do you think others would describe you? Fun
What would you say is your strongest personal trait and why? Independent, strong-willed.
What is your favorite sport? Swimming
Describe your own athletic ability/skills: Very athletic, a fast learner.
What is your favorite type of music? Hip hop
Why is this your favorite type of music? It’s fun to dance to. Describe your own musical abilities/skills: Minimal
What is your favorite book? Any book by Danielle Steele Why? She’s a great writer.
What is your favorite movie? The Notebook
Why? It’s very romantic
Describe your own artistic abilities/skills: Average
Do you speak any foreign languages? Spanish
Have you had any unique travel experiences that you feel have helped shape your way of thinking and/or the way you live your life?
No, but I would love to go to Italy.
Have you had any unique educational experiences? Receiving perfect attendance.
If you were given enough funds to spend one year of your life to engage in any recreational, political, religious/spiritual, or other endeavor of particular importance to you, what would you choose to do? I would buy a house for my family, travel, save money for my children’s education and save money for vacations.
Philosophies and Thoughts
What is your philosophy on life? We are all here for a reason.
How did you come to have this philosophy on life? Good and bad life experiences.
What is your ultimate goal and ambition in life? To be a great mother, wife, and teacher.
How do you plan on achieving this goal? By working hard.
Why do you want to be an egg donor? I’ve had the chance to experience giving birth and being a mom is one of the most rewarding gifts that God can give you.
What do you think egg donation means to potential recipients? The ability to have, learn, and raise life.
