Bond Surrogacy Services
Portland Office:
West Linn, OR 97068
United States
ph: 5037532429
fax: 15039667958
Surrogac
Make baby dreams come true for waiting Parents-to-be!
Compensation for first time donors average $7000.00 &up, plus travel expenses if needed, attorney contract fees. Experienced Egg Donors $8,000+
When you decide to donate your eggs, you are giving up all legal rights and responsibilities associated with the donated eggs and any born child as a result of them. The recipients have the right to determine how they wish to use these eggs. Your eggs may be used for one or more recipients.
Many egg donations are strictly anonymous, but some intended parents want to have additional contact with their donor. This could mean a one-time, facilitated meeting or an exchange of emails. The most common request is for the donor to sign up for the Donor-Sibling Registry, or DSR. The DSR is a website that allows for anonymous future contact between the donor and her recipient family. You may choose if you are open to additional contact or if you wish to be matched only for anonymous donations.
As with any medical procedure, there are possibility of side effects and risks. Many women feel very minor or no discomfort during the donation cycle. Others have varying symptoms that typically resolve after the egg retrieval procedure. To date, evidence doesn't’t suggest any increased risk of breast or ovarian cancer or increased risk of infertility for women who have donated eggs.
Cut and Paste Application
EGG DONOR APPLICATION
1. Are you eligible to work in the United States?
2. Are you a US citizen or permanent resident?
3. What is your FIRST name?
4. With this treatment, you will need to travel to Portland, OR for one day at the start of treatment and for one week at the time of egg retrieval (no cost to you). You will also need to go to a nearby fertility center on a periodic (sometimes daily) basis. Which metropolitan area is closest to you?
5. Are you currently enrolled as an egg donor in another program?
6. Have you donated eggs before?
7. How many times have you donated your eggs?
8. Would you also like to be considered for the Gestational Surrogate Carrier program in the future?
9. What is your highest level of completed education?
10. Is your work schedule flexible?
11. What is the highest number of consecutive days that you have been incarcerated?
12. Are you adopted?
13. Are there known genetic problems in your family?
If "Yes" Please Explain
14. Have you spent 3 months or more, cumulatively, in the UK (England, Northern Ireland, Scotland, Wales, the Isle of Man, the Channel Islands, Gibraltar, or the Falkland Islands) from the beginning of 1980 through the end of 1996?
15. Have you lived cumulatively for 5 years or more in Europe (Albania, Austria, Belgium, Bosnia-Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Liechtenstein, Luxembourg, Macedonia, Netherlands, Norway, Poland, Portugal, Romania, Slovak Republic, Slovenia, Spain, Sweden, Switzerland, England, Northern Ireland, Scotland, Wales, Isle of Man, Channel Islands, Gibraltar, Falkland Islands, and Yugoslavia) from 1980 until present?
16. Are you a current or former US military member, civilian military employee, or dependent of a military member or civilian employee, who has resided at US military bases in northern Europe (Germany, Belgium, and the Netherlands) for 6 months or more cumulatively from 1980 through 1990, or elsewhere in Europe (Greece, Turkey, Spain, Portugal, or Italy) for 6 months or more cumulatively from 1980 through 1996?
17. Have you had any serious illness in the past?
If "Yes" Please Describe
18. Do you have any chronic medical problems or conditions?
If "Yes" Please Explain
19. How many cigarettes do you smoke per day?
20. When is the last time you took recreational drugs (cocaine, LSD, heroin, barbiturates, narcotics, opiates, amphetamines, hallucinogens, tranquilizers, PCP, steroids for non-medical reasons, etc.)?
21. What is your date of birth?
22. What is your ethnic background? “X” beside all that apply:
African
Arab
Chinese
Dutch
English
Filipino
French
French Canadian
German
Greek
Indian
Irish
Italian
Japanese
Jewish
Korean
Latino
Mexican
Native American
Norwegian
Pacific Islander
Pakistani
Polish
Portuguese
Russian
Scandinavian
Scottish
Spanish
Swedish
Ukranian
Vietnamese
Other
Add Explanation if Desired
23. What is your height?
24. What is your weight in pounds?
25. How long is your menstrual cycle (first day of one period to first day of the next)?
26. What is your current method of birth control? “X” beside all that apply:
None
Birth Control Pills
Condom
Depo-Provera
Diaphragm
Fertility Awareness
Implanon
IUD - Mirena
IUD - Non-hormonal
Nuva Ring
Ortho Evra
Spermicide
Tubal Ligation
Vasectomy
Other
If "Other" Please Explain
27. When was the last time you had a Depo Provera injection?
28. Are you currently breastfeeding?
If "Yes" How long do you plan to continue?
29. Donations are usually reimbursed at approximately $7000.00 plus all travel expenses (if not within 100 miles of clinic), meals, lodging, childcare, attorney fees. How much in lost wages and child care for 7 days total time for travel will you need to be reimbursed at? $
30. Have you had a psychological evaluation? Been diagnosed with ADHD, anxiety, learning disorder, or have a family history of mental health issues? Explain in detail:
31. Have you been diagnosed or have a family history of physical health issues; diabetes, hypertension, sickle cell anemia, cancer, deep vein thrombosis, fertility issues? Please explain in detail:
32. Are there any types of people you would not like to consider donating to? Please list restrictions below:
Copyright 2008-2016 Bond Surrogacy Services, Bond Surrogacy and Escrow Services. All rights reserved.
Bond Surrogacy Services
Portland Office:
West Linn, OR 97068
United States
ph: 5037532429
fax: 15039667958
Surrogac