Third-Party Birth Story Survey to Optimize Health Care

Thank you for taking the time to complete the Third-Party Reproduction Survey. The goal is to capture your birth story, along with the impact it has or has not had on your health care. Let’s make sure the medical community views donor conception and adoption as a normal part of the medical intake process. After all, no one deserves to be “other”.

In completing the survey, you are helping us collect information from donor-conceived people/person (DCP), adoption, or recipient parents (RP). Capturing your story and others will allow us to present actual situations to the medical associations to substantiate the need to ask someone about their conception on the medical intake form and process.  The goal is to improve health outcomes physically, emotionally, and financially.

We want to know if your birth story impacted how you were medically diagnosed and treated if you choose to share it.

Please complete the questions with yes or no and, whenever possible, share your experience at the end of each question and anything you’d like to add or miss or a specific story at the end of the survey.  Everyone deserves to feel that their birth story is recognized and “normal.”

Birth Story Survey
Contact Information (optional):
Are you completing this form yourself?
Medical Information:
Did the medical professional ask about your donor conception or birth story?
Was there an option on a form for your donor conception or birth story?
If there was no option, did you advise the health care worker of your donor conception or birth story since you were not asked?
If there was an option, did you decline to inform?
If not on the form, were you asked about your donor conception or birth story?
Did the medical professional allow you to feel comfortable in sharing your story?
Treatment Provided:
If you shared your donor conception or birth story, do you believe your care was provided taking your DNA into account?
If you did not share your donor conception or birth story, do you believe it may have taken longer to find a diagnosis or treatment for your condition?
Do you think replacing the word “other” with donor and adoption will be helpful when a medical history is taken & on the medial intake form?

Thank you again for taking the time to complete the survey. Your story matters!

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