I Want to be an Egg Donor — Screening Form

Thank you for your interest in becoming an Egg Donor! If you have unanswered questions, please give us a call so we can help guide you in the right direction.

Please make sure that you meet all of the following requirements and fully understand the complete process prior to completing the online screening.

  • Must be genetically female between the ages of 20-29 years old
  • Body Mass Index (BMI) lower than 28 (BMI calculator)
  • High School Diploma
  • A college education is highly desirable, but not mandatory
  • Non-smoker
  • No current use of drugs or excessive alcohol
  • No tattoos or piercings within the last 12 months
  • Healthy┬ápersonal and family medical history
  • No more than one occurrence of the same cancer in family history (except non-genetic cancers, such as leukemia and lung).
  • Understand the time commitment and dedication it takes to complete a cycle

If you meet the above criteria, please complete the form below.

E-mail Address
Confirm E-mail Address
First Name
Middle Name
Last Name
Maiden Name
Address
 
City
State
ZIP
County
Mobile Phone Number
Format: ###-###-####
Creative Conception, Inc. may send me text messages at this number
Birth Date
Height
Weight lbs.
Natural Hair Color
Eye Color
Mother's Ethnicity Click to Select
Father's Ethnicity Click to Select
Marital Status
Are you a smoker?
Are you on Birth Control?
Have you ever donated eggs before?
Comments or Questions?