Become an Egg Donor

Looking to Become an Egg Donor? This will be an amazing, beautiful experience that you will never forget. We look forward to hearing from you and helping you through the process of creating the gift of life and family.

As egg donors, please take some time to review the egg donation process, requirements, compensation package and donor FAQs before completing our egg donor application.

As soon as you feel confident to give the priceless gift of family to a couple in need, take the first step to becoming a Giving Hope Egg Donor by completing our egg donor application below.

Donor Application Form

Contact Information

Full Name

Phone Number

City

State

Your Email

Best Time to Contact

To expedite the prescreen process, please upload a photo of yourself. Please make sure that your entire face is visible - no sunglasses or hats, please.

Your Physical Attributes

Age

Weight (lbs)

Height (feet)

(inches)

Eye Color

Natural Hair Color

Select a maximum of five (5) ethnicities. Hold the Control Key (Option Key on Mac) while clicking to add/remove additional selections. If you do not see your ethicity listed, please add it to the comments below.
Note: Please be specific (not Caucasian, European, Asian, etc.)

Additional Information

Birth Control

Type

Smoker

Have you donated before?

Do you have any children?

College Education

Occupation

Full/Part Time

Family History

Your Comments

How did you hear about us?

Name?

Required Questions

FDA regulations require that we ask you the following questions. Your complete honesty and accuracy are essential and appreciated. A "Yes" answer to any of the following questions will not necessarily disqualify you.


1.  Yes No In the past 12 months, have you had a blood transfusion?
2.  Yes No Have you ever had a blood transfusion in England, Wales, Scotland, Northern Ireland, Channel Islands, Isle of Man, Gibraltar or Falkland Islands?
3.  Yes No In the past 12 months, have you had sex with any person who has ever received human-derived clotting factor concentrates?
4.  Yes No Have you ever received human pituitary-derived growth hormone or beef-derived insulin?
5.  Yes No In the past 12 months, have you had any tissue transplantation or ever had a transplantation of cornea (covering of the eye) or dura mater (covering of the brain)?
6.  Yes No Have you or any of your blood relatives ever had Creutzfeldt-Jakob disease or been told you are at risk for it?
7.  Yes No In the past 5 years, have you used injectable (I.V.) drugs for non-medical purposes?
8.  Yes No In the past 12 months, have you had sex with someone who has used I.V. drugs?
9.  Yes No In the past 12 months, have you had sex with a man who has had sex with another man?
10.  Yes No In the past 12 months, have you had sex with any person known or suspected to have HIV infection, clinically active Hepatitis B infection or Hepatitis C infection?
11. Provide Number In the past 6 months, how many sexual partners have you had?
12.  Yes No In the past 5 years, have you ever had sex for money or drugs?
13.  Yes No In the past 12 months, have you been exposed to known or suspected HIV, Hepatitis B, and/or Hepatitis C through infected blood by inoculation (i.e., needle stick) or through contact with an open wound or mucous membrane such as eye or mouth?
14.  Yes No In the past 12 months, have you been held in jail, prison or correctional facility for more than 72 hours?
15.  Yes No In the past 12 months, have you had any body piercings, ear piercings, tattoos, or acupuncture in which shared instruments are known to have been used?
16.  Yes No Have you ever been diagnosed with clinical, symptomatic or viral Hepatitis?
17.  Yes No In the past 2 months, have you had a smallpox vaccination or have you had contact with the smallpox vaccination site of another person?
18.  Yes No In the past month, have you had direct contact with a person with or suspected to have SARS or West Nile Virus?
19.  Yes No In the past 7 days, have you had a fever with a headache?
20.  Yes No In the past 14 days, have you had an open sore or infection?
21.  Yes No Have you, your partner or any member of your household ever had a transplant or medical procedure that involved being exposed to lives cells, tissues or organs from an animal?
22.  Yes No I understand that I must not have any vaccination within one month of egg/sperm donation.
23.  Yes No In the past 28 days, have you had a temperature >100.4, cough, shortness of breath, difficulty breathing, hypoxia or x-rays, indicating pneumonia or acute respiratory distress syndrome?