EmailMeForm
Egg Donor - Extended Profile USA
Welcome to Cryos’ Extended Profile Questionaire.
Before you fill out your Extended Profile it is important that you read our Privacy Policy. You can find our Privacy Policy here: https://www.cryosinternational.com/en-us/us-shop/client/legal/privacy-policy/
Advice before filling out the form:
• Please fill out as much as possible in English.
• Read the questionnaire thoroughly before you start filling out the form, as most of the questions are obligatory to answer (marked with a red *).
• It is possible to save you answers along the way by using the link at the bottom of the page next to the Submit button. Your answers will be saved for a maximum of 5 days, before it is reset.
• When you click the Save button, please copy and save the link on the following page, as it is a different link than the one given to you by the Cryos staff.
• We advise you to gather all the information you will need before you start. Of particular concern is the section about family information, the handwritten motivation and baby photos in the last part of the form.
• Please leave out any identifying information about yourself in your answers other than your name and ID-number.
• It is important that you give the profile a personal touch. Elaborate and comment on your own answers. Example of a question:
What childhood event left the biggest impression on you? "When I was ten years old, my grandparents took me and my sister camping for a whole week. We picked wild berries, played hide-and-seek in the forest and went swimming in the lake. Nights were spent around the bonfire and while enjoying the berry pies my grandmother had made, my grandfather told stories about the old days and about all the important things in life. This was a great bonding experience and it created a lasting memory of spending time with my grandparents."
We, of course, make sure that your name, ID number and email address is not going to appear in the final profile.
It generally takes 1 - 1.5 hours to complete the form.
Enjoy!
Name
*
First
Last
ID-number
*
Email
*
In which Cryos department are you a donor?
*
Orlando
Health
Do you wear glasses or lenses:
*
Glasses
Lenses
No
Do you eat healthy?
*
I wish
I try
Always
Education & Occupation
Did you attend or are you attending high school, business school, technical school, or similar?
Yes
No
If yes, what did you do immediately after you graduated?
If yes, please state which
Are you or have you been attending university or any other higher education?
Yes
No
If yes, please describe at which level (Academy Profession, Bachelor's degree, Master, PhD, or other) and the field of study (business administration, art, education, etc.)
If yes, what was your major/emphasis/focus of study? What other courses did you take? (please be detailed)
How many years of education have you had in total (including primary and lower secondary school)?
How many additional years do you plan to spend on education?
If you plan to spend additional years on your education, what type of schooling/degree will you be pursuing?
Please describe your current education and/or job
*
Which jobs have you had (please list all)?
*
What is/are your overall education/career goal(s)?
*
What is your native language?
*
Which other languages do you speak?
*
Have you carried out any volunteer work? If so, please state which
Do you have any professional certifications/licenses? If yes, please state which
Have you been in the military?
*
Yes
No
If yes, please state rank
Personality
Which words describe your personality? (minimum 5 words)
*
Describe your strong sides
*
Describe your weak sides
*
Marital status?
*
Single
In a relationship
Married
Which types of sports do you play or have played?
*
Which other types of sports are you interested in?
*
List any other hobbies you may have or have had
*
List which musical instruments you play or have played
*
Name the countries have you visited
*
Describe the best vacation you have had
*
Describe the things you like the most about your country
*
Who are your idols, heroes and heroines, and why?
*
What were your childhood dreams?
*
What is/are your goal(s) in life?
*
Which value(s) do you rank the highest?
*
Which childhood experience made the biggest impression on you?
*
What is your favorite...(please state why)
Animal
*
Food
*
Music
*
Car
*
Time of year
*
(For example summer or Christmas)
Book and/or Author
*
Movie and/or Director
*
Which experience/moment in your life was your...
Greatest
*
Happiest
*
Funniest
*
Scariest
*
Proudest
*
Greatest sorrow
*
Most dangerous
*
If you have something to add regarding your personality or type, please feel free to add it here
Family Information
Help for filling out this section:
• Under ‘Health’ please indicate "Good" for healthy and write shortly about any disease or cause of death.
• If he/she is no longer alive, indicate age at time of death.
Paternal Grandfather
Age
*
Alive?
*
Yes
No
Race
*
(African, American Indian, Asian, Caucasian, Hispanic and/or Middle Eastern)
Ethnicity
*
(Ethnicity refers to the ethnic origin of a person's ancestors – where your family comes from. Examples of ethnicities are German, Irish, Venezuelan, etc. Ethnicity should not be confused with race or citizenship)
Health
*
Paternal Grandmother
Age
*
Alive?
*
Yes
No
Race
*
(African, American Indian, Asian, Caucasian, Hispanic and/or Middle Eastern)
Ethnicity
*
(Ethnicity refers to the ethnic origin of a person's ancestors – where your family comes from. Examples of ethnicities are German, Irish, Venezuelan, etc. Ethnicity should not be confused with race or citizenship)
Health
*
Maternal Grandfather
Age
*
Alive?
*
Yes
No
Race
*
(African, American Indian, Asian, Caucasian, Hispanic and/or Middle Eastern)
Ethnicity
*
(Ethnicity refers to the ethnic origin of a person's ancestors – where your family comes from. Examples of ethnicities are German, Irish, Venezuelan, etc. Ethnicity should not be confused with race or citizenship)
Health
*
Maternal Grandmother
Age
*
Alive?
*
Yes
No
Race
*
(African, American Indian, Asian, Caucasian, Hispanic and/or Middle Eastern)
Ethnicity
*
(Ethnicity refers to the ethnic origin of a person's ancestors – where your family comes from. Examples of ethnicities are German, Irish, Venezuelan, etc. Ethnicity should not be confused with race or citizenship)
Health
*
Father
Age
*
Alive?
*
Yes
No
Health
*
Mother
Age
*
Alive?
*
Yes
No
Health
*
Sibling 1
Gender
Full or half sibling
Age
Alive?
Yes
No
Health
Sibling 2
Gender
Full or half sibling
Age
Alive?
Yes
No
Health
Sibling 3
Gender
Full or half sibling
Age
Alive?
Yes
No
Health
Sibling 4
Gender
Full or half sibling
Age
Alive?
Yes
No
Health
Sibling 5
Gender
Full or half sibling
Age
Alive?
Yes
No
Health
Sibling 6
Gender
Full or half sibling
Age
Alive?
Yes
No
Health
Do you have any children?
*
Yes
No
Attach a handwritten message (please read the instructions below)
*
The message must be written in English and at least 100 words, but preferably more (maximum 500 words). The message is for people who consider using your donation to have a baby. You can, for example, write about your motivation for becoming a donor or a personal greeting to children or the future parent/parents.
Please do not mention any identifying information, such as your name, or refer to yourself as “mother” or the like in relation to the children.
The message must be handwritten by you on a white A4-sized paper with a black pen.
Attach the message as a scanned file in one of the following formats: pdf, jpeg, png, etc. If it is not possible for you to scan the message and attach it here, please bring it to Cryos. Then we will take care of it for you.
Attach a voice recording in which you read your handwritten message out loud (please read the instructions below)
*
Attach an audio file in which you read out loud your handwritten message. The voice recording must be loud and clear and without any background noise.
Please do not mention any identifying information, such as your name.
Attach the voice recording as an audio file. You can make the recording with a mobile phone, iPod, computer, dictaphone, etc. If it is not possible for you to make the recording yourself, we can help you the next time you visit Cryos.
Attach photos of yourself as a baby/child (please read the instructions below)
*
Please attach a few photos of you as a baby/child (preferably about 3 photos).
The photos must be digital. If you only have photos in print, please do not use your phone or camera to take a picture of the printed photo in an album or frame. Use a scanner instead or bring the photos with you next time you visit Cryos. Then we will scan the photos for you.
The photos must be high quality and preferably portraits. If there are family members or other identifying subjects in the photos, we will make sure to remove these.
Attach a photo of yourself as a baby/child
*
If you have more photos of yourself as a baby or child, please upload them here.
Attach a photo of yourself as a baby/child
If you have more photos of yourself as a baby or child, please upload them here.
Attach a photo of yourself as an adult
Attach a photo of yourself as an adult
Attach a photo of yourself as an adult
Date filled out
*
DD
/
MM
/
YYYY
Thank you for filling out the form!
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