Thank you for taking your time to complete this form about your pregnancy.
We guarantee complete confidentiality. No identifying information will be released. This report will only be used to record children born from a particular donor, and to track for the purpose of birth limits.
Please return to this form again and keep us updated in the (unlike) event of your pregnancy being terminated without a live-born child (missed abortion, stillbirth etc.)
If you have any questions or need help to fill in the form, please don’t hesitate to call us at +45 20 55 65 95 or send an e-mail to email@example.com
Please provide the following information for each clinical pregnancy.