Donor Eligibility Quiz

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Thank you for taking the first step towards becoming a stool donor. Your willingness to contribute is invaluable.

Our eligibility quiz is designed to gather basic health information to determine if you meet the initial requirements for stool donation. If you successfully pass this initial assessment, you’ll receive a more comprehensive health and wellness questionnaire.

Are you between the ages of 10-30?
*

Yes

Required

Option 1

Clear selection

Are you under the age of 18?
*

Yes

Please provide your first and last name *

Please enter your email *

Are you located in the Fraser Valley region?
*

Yes

Are you currently taking any antibiotics, antifungals, antivirals, immune suppressants, or chemotherapy? *

Yes

When was the last time you took antibiotics? *

Last 6 months

Last 12 months

1+ years

Never in my lifetime

I don't know, but I can find out

Were you born vaginally?
*

Yes

Other:

Do you eat a balanced and diverse omnivore diet? *

Yes

Are you physically active? *

Yes

Are you a smoker (both tobacco and cannabis)?
*

Yes

Do you have a gut disorder, including irritable bowel syndrome, inflammatory bowel disease (including Crohn’s and ulcerative colitis), suffered from any symptoms of gastrointestinal disorder, or any gastric-related cancer?
*

Yes

Have you had any of the following infectious diseases: HIV, HTLV, Syphilis, Hepatitis B, Hepatitis C?
*

Yes

Have you been diagnosed with any neurological, psychiatric (i.e. Anxiety or Depression), or neurodevelopmental (i.e Autism, ADHD) disorder?
*

Yes

Have you been diagnosed with any auto-immune disease, heart disease, diabetes, high cholesterol, stroke, chronic pain syndrome or any cancers?
*

Yes

Have you been a recipient of any viable/ non-viable human cells or tissues or had a transplant?
*

Yes

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