Recipient info
This info is used to provide FedEx with contact info in case of shipping troubles..
Fed-ex Delivery address
please only enter the address where you plan to receive your Fedex shippment. I can ship Monday-Friday with delivery on Tuesday-Sat only Saturday delivery is $16 more
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Name
*
First Name
Last Name
Phone Number- In case of shipping trouble or backup contact info.
*
-
Area Code
Phone Number
Please enter the Date around when you expect next ovulation or LH surge for the cycle you are wishing to try for.
*
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Month
-
Day
Year
Date
Tell me a little about yourself (not required) but is helpful in remembering who you are when we chat
Are you okay with receiving text updates during shipping to the number provided?
*
Yes text is okay
No
Email is okay
Email For backup contact so i can reach you.
*
example@example.com
What is your screen name for KDR or just a baby App ( so i may link up whos info this is)
*
The following questions help plan a date to ship on
all info is kept private.
How long have you been in your current relationship? Are you currently married or planning on marriage?
*
Have you had a previous Birth or pregnancy?
*
Are your cycles regular or do they fluctuate? Average amount of days in cycle?
*
Have you tried to become pregnant before and weren't successful? if so what type of fertility tests have been done if any
*
Have you ever been diagnosed with PCOS?
*
Yes
NO
Not sure i haven't done testing
Yes AND i failed to get pregnant in the past
Current employment Title and length .
*
Do you have savings set aside for birth or complications?
*
Yes 1-2k
Yes 2-5k
Yes 5-7k
Yes 7-10k
Yes 10,000+ set aside.
No i do not have savings set aside.
Current age
*
The Length you have been trying to conceive for without success. ( if you have been trying)
Do you currently take a preconception vitamin or prenatal?
*
if so how long have you been taking it for? and which brand
Are you okay with future contact or updates during or after pregnancy? select all that apply
Yes i'm okay updating you on how things are going
Yes i'm okay with future contact or uncle type role later in life.
NO contact but updates are okay
NO future contact or updates after pregnancy.
Allergy information depending on the cryopreservative buffer that is used it may be derived from soy Lecithin, Milk ( Lecithin) , TYB ( contains commercial egg yoke+ gentamicin ), Or Glycerin plant-based. Are you allergic to any of these or Antibiotics such as gentamicin sulfate? If so other animal free media buffers are available such as HEPES
*
Any questions you have or other info you would like to provide can be entered below. Thank you for taking the time to fill out the form! I will get back to you as soon as possible by email or text whichever you prefer. Thank you for considering me as your Donor Looking forward to chatting with you!
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