CDD Donor – The Centre of Excellence for Gastroenerology

Thank you for taking the time to complete our survey and for expressing your interest. Unfortunately, at this stage, we are only considering participants residing in Sydney, as our laboratories are located in Sydney. Thank you for your understanding.

QUESTION 1*
How old are you?

QUESTION 1 - How old are you?

Under 16 years

16-60 years

Over 60 years

Thank you for your interest in becoming an FMT donor. Unfortunately, at this time, you are not eligible.

QUESTION 2*
Have you had antibiotics in the last 3 months?

QUESTION 2 - Have you had antibiotics in the last 3 months?

Yes

QUESTION 3*
Do you currently work?

QUESTION 3 - Do you currently work?

In a healthcare facility and have direct patient contact?

With children?

With animals?

None of the above

Thank you for your interest in becoming an FMT donor. Unfortunately, at this time, you are not eligible.

QUESTION 4*
Have you been diagnosed with a Gastrointestinal condition?

QUESTION 4 - Have you been diagnosed with a Gastrointestinal condition?

Yes

Thank you for your interest in becoming an FMT donor. Unfortunately, at this time, you are not eligible.

QUESTION 5*
Do you suffer from any blood borne disease or sexually transmitted infection?

QUESTION 5 - Do you suffer from any blood borne disease or sexually transmitted infection?

Yes

Thank you for your interest in becoming an FMT donor. Unfortunately, at this time, you are not eligible.

QUESTION 6*
Have you ever noticed blood in your stool?

QUESTION 6 - Have you ever noticed blood in your stool?

Yes

Thank you for your interest in becoming an FMT donor. Unfortunately, at this time, you are not eligible.

QUESTION 7*
Have you ever had cancer?

QUESTION 7 - Have you ever had cancer?

Yes

Thank you for your interest in becoming an FMT donor. Unfortunately, at this time, you are not eligible.

QUESTION 8*
If you are accepted as a Donor, would you be willing to follow a healthy, whole food, high fibre diet and avoid foods that present a higher risk of carrying food borne infections (such as shellfish, processed meats and soft cheeses)?

QUESTION 8 - If you are accepted as a Donor, would you be willing to follow a healthy, whole food, high fibre diet and avoid foods that present a higher risk of carrying food borne infections (such as shellfish, processed meats and soft cheeses)?

Yes

Thank you for your interest in becoming an FMT donor. Unfortunately, at this time, you are not eligible.

QUESTION 9*
Would you be able to drop off your stool to the Centre for Digestive Diseases in Five Dock, Sydney between Monday- Friday, no later than 12pm and within 3 hrs hours of having opened your bowels?

QUESTION 9 - Would you be able to drop off your stool to the Centre for Digestive Diseases in Five Dock, Sydney between Monday- Friday, no later than 12pm and within 3 hrs hours of having opened your bowels?

Yes

Thank you for your interest in becoming an FMT donor. Unfortunately, at this time, you are not eligible.

QUESTION 10*
Would you be willing to undergo a telephone interview, a face to face interview, physical assessment, stool, blood and COVID-19 screening tests as part of the process towards becoming a donor?

QUESTION 10 - Would you be willing to undergo a telephone interview, a face to face interview, physical assessment, stool, blood and COVID-19 screening tests as part of the process towards becoming a donor?

Yes

Great! It looks like you might be right for the Donor program.
Click the "Submit Form" button below and one of our Donor team members will contact you

Thank you for your interest in becoming an FMT donor. Unfortunately, at this time, you are not eligible.

CDD FMT DONOR QUESTIONNAIRE