{"id":301,"date":"2014-01-06T18:31:42","date_gmt":"2014-01-06T18:31:42","guid":{"rendered":"http:\/\/test.seattlespermbank.ca\/?page_id=301"},"modified":"2017-04-04T14:00:22","modified_gmt":"2017-04-04T21:00:22","slug":"pregnancy-reporting","status":"publish","type":"page","link":"https:\/\/www.seattlespermbank.ca\/fr\/services\/pregnancy-reporting\/","title":{"rendered":"Pregnancy and Birth Reporting"},"content":{"rendered":"<div>\n<p>Thank you for completing our pregnancy and birth report form. Please return to this page with any updates regarding your pregnancy.<\/p>\n<p>The information you provide is kept strictly confidential.\u252c\u00e1This report will only be used to record children born from a particular donor, and to track for the purpose of birth limits.<\/p>\n<p>If you have any questions, someone from our lab is always available to assist you.  Please feel free to call us at 1-206-588-1484 or send an email to <a href=\"mailto:cs@seattlespermbank.com\">cs@seattlespermbank.com<\/a>.<\/p>\n<\/div>\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f300-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"300\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/fr\/wp-json\/wp\/v2\/pages\/301#wpcf7-f300-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\" data-trp-original-action=\"\/fr\/wp-json\/wp\/v2\/pages\/301#wpcf7-f300-o1\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"300\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f300-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<p><span id=\"wpcf7-6a156db7c0df9-wrapper\" class=\"wpcf7-form-control-wrap IncludeMe138-wrap\" style=\"display:none !important; visibility:hidden !important;\"><label for=\"IncludeMe138\" class=\"hp-message\">Please leave this field empty.<\/label><input id=\"IncludeMe138\"  class=\"wpcf7-form-control wpcf7-text\" type=\"text\" name=\"IncludeMe138\" value=\"\" size=\"40\" tabindex=\"-1\" autocomplete=\"new-password\" \/><\/span>\n<\/p>\n<div>\n\t<p><label for=\"reporting-type\">Type of Report: *<\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"reporting-type\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required reporting-type\" id=\"reporting-type\" aria-required=\"true\" aria-invalid=\"false\" name=\"reporting-type\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Pregnancy\">Pregnancy<\/option><option value=\"Birth\">Birth<\/option><option value=\"Other\">Other<\/option><\/select><\/span>\n\t<\/p>\n<\/div>\n<div>\n\t<p><label for=\"patient-first-name\">Patient first name: *<\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"patient-first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"patient-first-name\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"patient-first-name\" \/><\/span>\n\t<\/p>\n<\/div>\n<div>\n\t<p><label for=\"patient-last-name\">Patient last name: *<\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"patient-last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"patient-last-name\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"patient-last-name\" \/><\/span>\n\t<\/p>\n<\/div>\n<div>\n\t<p><label for=\"zip-code\">Zip code: *<\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"zip-code\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"zip-code\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zip-code\" \/><\/span>\n\t<\/p>\n<\/div>\n<div>\n\t<p><label for=\"country\">Country: *<\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"country\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" id=\"country\" aria-required=\"true\" aria-invalid=\"false\" name=\"country\"><option value=\"United States\">United States<\/option><option value=\"Canada\">Canada<\/option><option value=\"Afghanistan\">Afghanistan<\/option><option value=\"Albania\">Albania<\/option><option value=\"Algeria\">Algeria<\/option><option value=\"American Samoa\">American Samoa<\/option><option value=\"Andorra\">Andorra<\/option><option value=\"Angola\">Angola<\/option><option value=\"Anguilla\">Anguilla<\/option><option value=\"Antarctica\">Antarctica<\/option><option value=\"Antigua and Barbuda\">Antigua and Barbuda<\/option><option value=\"Argentina\">Argentina<\/option><option value=\"Armenia\">Armenia<\/option><option value=\"Aruba\">Aruba<\/option><option value=\"Australia\">Australia<\/option><option value=\"Austria\">Austria<\/option><option value=\"Azerbaidjan\">Azerbaidjan<\/option><option value=\"Bahamas\">Bahamas<\/option><option value=\"Bahrain\">Bahrain<\/option><option value=\"Bangladesh\">Bangladesh<\/option><option value=\"Barbados\">Barbados<\/option><option value=\"Belarus\">Belarus<\/option><option value=\"Belgium\">Belgium<\/option><option value=\"Belize\">Belize<\/option><option value=\"Benin\">Benin<\/option><option value=\"Bermuda\">Bermuda<\/option><option value=\"Bhutan\">Bhutan<\/option><option value=\"Bolivia\">Bolivia<\/option><option value=\"Bosnia-Herzegovina\">Bosnia-Herzegovina<\/option><option value=\"Botswana\">Botswana<\/option><option value=\"Bouvet Island\">Bouvet Island<\/option><option value=\"Brazil\">Brazil<\/option><option value=\"British Indian Ocean Territory\">British Indian Ocean Territory<\/option><option value=\"Brunei Darussalam\">Brunei Darussalam<\/option><option value=\"Bulgaria\">Bulgaria<\/option><option value=\"Burkina Faso\">Burkina Faso<\/option><option value=\"Burundi\">Burundi<\/option><option value=\"Cambodia\">Cambodia<\/option><option value=\"Cameroon\">Cameroon<\/option><option value=\"Cape Verde\">Cape Verde<\/option><option value=\"Cayman Islands\">Cayman Islands<\/option><option value=\"Central African Republic\">Central African Republic<\/option><option value=\"Chad\">Chad<\/option><option value=\"Chile\">Chile<\/option><option value=\"China\">China<\/option><option value=\"Christmas Island\">Christmas Island<\/option><option value=\"Cocos (Keeling) Islands\">Cocos (Keeling) Islands<\/option><option value=\"Colombia\">Colombia<\/option><option value=\"Commercial\">Commercial<\/option><option value=\"Comoros\">Comoros<\/option><option value=\"Congo\">Congo<\/option><option value=\"Cook Islands\">Cook Islands<\/option><option value=\"Costa Rica\">Costa Rica<\/option><option value=\"Croatia\">Croatia<\/option><option value=\"Cuba\">Cuba<\/option><option value=\"Cyprus\">Cyprus<\/option><option value=\"Czech Republic\">Czech Republic<\/option><option value=\"Denmark\">Denmark<\/option><option value=\"Djibouti\">Djibouti<\/option><option value=\"Dominica\">Dominica<\/option><option value=\"Dominican Republic\">Dominican Republic<\/option><option value=\"East Timor\">East Timor<\/option><option value=\"Ecuador\">Ecuador<\/option><option value=\"Egypt\">Egypt<\/option><option value=\"El Salvador\">El Salvador<\/option><option value=\"Equatorial Guinea\">Equatorial Guinea<\/option><option value=\"Eritrea\">Eritrea<\/option><option value=\"Estonia\">Estonia<\/option><option value=\"Ethiopia\">Ethiopia<\/option><option value=\"Falkland Islands\">Falkland Islands<\/option><option value=\"Faroe Islands\">Faroe Islands<\/option><option value=\"Fiji\">Fiji<\/option><option value=\"Finland\">Finland<\/option><option value=\"Former Czechoslovakia\">Former Czechoslovakia<\/option><option value=\"Former USSR\">Former USSR<\/option><option value=\"France\">France<\/option><option value=\"France (European Territory)\">France (European Territory)<\/option><option value=\"French Guyana\">French Guyana<\/option><option value=\"French Southern Territories\">French Southern Territories<\/option><option value=\"Gabon\">Gabon<\/option><option value=\"Gambia\">Gambia<\/option><option value=\"Georgia\">Georgia<\/option><option value=\"Germany\">Germany<\/option><option value=\"Ghana\">Ghana<\/option><option value=\"Gibraltar\">Gibraltar<\/option><option value=\"Great Britain\">Great Britain<\/option><option value=\"Greece\">Greece<\/option><option value=\"Greenland\">Greenland<\/option><option value=\"Grenada\">Grenada<\/option><option value=\"Guadeloupe (French)\">Guadeloupe (French)<\/option><option value=\"Guam (USA)\">Guam (USA)<\/option><option value=\"Guatemala\">Guatemala<\/option><option value=\"Guinea\">Guinea<\/option><option value=\"Guinea Bissau\">Guinea Bissau<\/option><option value=\"Guyana\">Guyana<\/option><option value=\"Haiti\">Haiti<\/option><option value=\"Heard and McDonald Islands\">Heard and McDonald Islands<\/option><option value=\"Honduras\">Honduras<\/option><option value=\"Hong Kong\">Hong Kong<\/option><option value=\"Hungary\">Hungary<\/option><option value=\"Iceland\">Iceland<\/option><option value=\"India\">India<\/option><option value=\"Indonesia\">Indonesia<\/option><option value=\"International\">International<\/option><option value=\"Iran\">Iran<\/option><option value=\"Iraq\">Iraq<\/option><option value=\"Ireland\">Ireland<\/option><option value=\"Israel\">Israel<\/option><option value=\"Italy\">Italy<\/option><option value=\"Ivory Coast (Cote D&#039;Ivoire)\">Ivory Coast (Cote D&#039;Ivoire)<\/option><option value=\"Jamaica\">Jamaica<\/option><option value=\"Japan\">Japan<\/option><option value=\"Jordan\">Jordan<\/option><option value=\"Kazakhstan\">Kazakhstan<\/option><option value=\"Kenya\">Kenya<\/option><option value=\"Kiribati\">Kiribati<\/option><option value=\"Kuwait\">Kuwait<\/option><option value=\"Kyrgyzstan\">Kyrgyzstan<\/option><option value=\"Laos\">Laos<\/option><option value=\"Latvia\">Latvia<\/option><option value=\"Lebanon\">Lebanon<\/option><option value=\"Lesotho\">Lesotho<\/option><option value=\"Liberia\">Liberia<\/option><option value=\"Libya\">Libya<\/option><option value=\"Liechtenstein\">Liechtenstein<\/option><option value=\"Lithuania\">Lithuania<\/option><option value=\"Luxembourg\">Luxembourg<\/option><option value=\"Macau\">Macau<\/option><option value=\"Macedonia\">Macedonia<\/option><option value=\"Madagascar\">Madagascar<\/option><option value=\"Malawi\">Malawi<\/option><option value=\"Malaysia\">Malaysia<\/option><option value=\"Maldives\">Maldives<\/option><option value=\"Mali\">Mali<\/option><option value=\"Malta\">Malta<\/option><option value=\"Marshall Islands\">Marshall Islands<\/option><option value=\"Martinique (French)\">Martinique (French)<\/option><option value=\"Mauritania\">Mauritania<\/option><option value=\"Mauritius\">Mauritius<\/option><option value=\"Mayotte\">Mayotte<\/option><option value=\"Mexico\">Mexico<\/option><option value=\"Micronesia\">Micronesia<\/option><option value=\"Moldavia\">Moldavia<\/option><option value=\"Monaco\">Monaco<\/option><option value=\"Mongolia\">Mongolia<\/option><option value=\"Montserrat\">Montserrat<\/option><option value=\"Morocco\">Morocco<\/option><option value=\"Mozambique\">Mozambique<\/option><option value=\"Myanmar\">Myanmar<\/option><option value=\"Namibia\">Namibia<\/option><option value=\"NATO (this was purged in 1996 - see hq.nato.int)\">NATO (this was purged in 1996 - see hq.nato.int)<\/option><option value=\"Nauru\">Nauru<\/option><option value=\"Nepal\">Nepal<\/option><option value=\"Netherlands\">Netherlands<\/option><option value=\"Netherlands Antilles\">Netherlands Antilles<\/option><option value=\"Network\">Network<\/option><option value=\"Neutral Zone\">Neutral Zone<\/option><option value=\"New Caledonia (French)\">New Caledonia (French)<\/option><option value=\"New Zealand\">New Zealand<\/option><option value=\"Nicaragua\">Nicaragua<\/option><option value=\"Niger\">Niger<\/option><option value=\"Nigeria\">Nigeria<\/option><option value=\"Niue\">Niue<\/option><option value=\"Non-Profit Making Organisations (sic)\">Non-Profit Making Organisations (sic)<\/option><option value=\"Norfolk Island\">Norfolk Island<\/option><option value=\"North Korea\">North Korea<\/option><option value=\"Northern Mariana Islands\">Northern Mariana Islands<\/option><option value=\"Norway\">Norway<\/option><option value=\"Old style Arpanet\">Old style Arpanet<\/option><option value=\"Oman\">Oman<\/option><option value=\"Pakistan\">Pakistan<\/option><option value=\"Palau\">Palau<\/option><option value=\"Panama\">Panama<\/option><option value=\"Papua New Guinea\">Papua New Guinea<\/option><option value=\"Paraguay\">Paraguay<\/option><option value=\"Peru\">Peru<\/option><option value=\"Philippines\">Philippines<\/option><option value=\"Pitcairn Island\">Pitcairn Island<\/option><option value=\"Poland\">Poland<\/option><option value=\"Polynesia (French)\">Polynesia (French)<\/option><option value=\"Portugal\">Portugal<\/option><option value=\"Puerto Rico\">Puerto Rico<\/option><option value=\"Qatar\">Qatar<\/option><option value=\"Reunion (French)\">Reunion (French)<\/option><option value=\"Romania\">Romania<\/option><option value=\"Russian Federation\">Russian Federation<\/option><option value=\"Rwanda\">Rwanda<\/option><option value=\"S. Georgia &amp; S. Sandwich Isls.\">S. Georgia &amp; S. Sandwich Isls.<\/option><option value=\"Saint Helena\">Saint Helena<\/option><option value=\"Saint Kitts &amp; Nevis Anguilla\">Saint Kitts &amp; Nevis Anguilla<\/option><option value=\"Saint Lucia\">Saint Lucia<\/option><option value=\"Saint Pierre and Miquelon\">Saint Pierre and Miquelon<\/option><option value=\"Saint Tome (Sao Tome) and Principe\">Saint Tome (Sao Tome) and Principe<\/option><option value=\"Saint Vincent &amp; Grenadines\">Saint Vincent &amp; Grenadines<\/option><option value=\"Samoa\">Samoa<\/option><option value=\"San Marino\">San Marino<\/option><option value=\"Saudi Arabia\">Saudi Arabia<\/option><option value=\"Senegal\">Senegal<\/option><option value=\"Seychelles\">Seychelles<\/option><option value=\"Sierra Leone\">Sierra Leone<\/option><option value=\"Singapore\">Singapore<\/option><option value=\"Slovak Republic\">Slovak Republic<\/option><option value=\"Slovenia\">Slovenia<\/option><option value=\"Solomon Islands\">Solomon Islands<\/option><option value=\"Somalia\">Somalia<\/option><option value=\"South Africa\">South Africa<\/option><option value=\"South Korea\">South Korea<\/option><option value=\"Spain\">Spain<\/option><option value=\"Sri Lanka\">Sri Lanka<\/option><option value=\"Sudan\">Sudan<\/option><option value=\"Suriname\">Suriname<\/option><option value=\"Svalbard and Jan Mayen Islands\">Svalbard and Jan Mayen Islands<\/option><option value=\"Swaziland\">Swaziland<\/option><option value=\"Sweden\">Sweden<\/option><option value=\"Switzerland\">Switzerland<\/option><option value=\"Syria\">Syria<\/option><option value=\"Tadjikistan\">Tadjikistan<\/option><option value=\"Taiwan\">Taiwan<\/option><option value=\"Tanzania\">Tanzania<\/option><option value=\"Thailand\">Thailand<\/option><option value=\"Togo\">Togo<\/option><option value=\"Tokelau\">Tokelau<\/option><option value=\"Tonga\">Tonga<\/option><option value=\"Trinidad and Tobago\">Trinidad and Tobago<\/option><option value=\"Tunisia\">Tunisia<\/option><option value=\"Turkey\">Turkey<\/option><option value=\"Turkmenistan\">Turkmenistan<\/option><option value=\"Turks and Caicos Islands\">Turks and Caicos Islands<\/option><option value=\"Tuvalu\">Tuvalu<\/option><option value=\"Uganda\">Uganda<\/option><option value=\"Ukraine\">Ukraine<\/option><option value=\"United Arab Emirates\">United Arab Emirates<\/option><option value=\"United Kingdom\">United Kingdom<\/option><option value=\"Uruguay\">Uruguay<\/option><option value=\"USA Educational\">USA Educational<\/option><option value=\"USA Government\">USA Government<\/option><option value=\"USA Military\">USA Military<\/option><option value=\"USA Minor Outlying Islands\">USA Minor Outlying Islands<\/option><option value=\"Uzbekistan\">Uzbekistan<\/option><option value=\"Vanuatu\">Vanuatu<\/option><option value=\"Vatican City State\">Vatican City State<\/option><option value=\"Venezuela\">Venezuela<\/option><option value=\"Vietnam\">Vietnam<\/option><option value=\"Virgin Islands (British)\">Virgin Islands (British)<\/option><option value=\"Virgin Islands (USA)\">Virgin Islands (USA)<\/option><option value=\"Wallis and Futuna Islands\">Wallis and Futuna Islands<\/option><option value=\"Western Sahara\">Western Sahara<\/option><option value=\"Yemen\">Yemen<\/option><option value=\"Yugoslavia\">Yugoslavia<\/option><option value=\"Zaire\">Zaire<\/option><option value=\"Zambia\">Zambia<\/option><option value=\"Zimbabwe\">Zimbabwe<\/option><\/select><\/span>\n\t<\/p>\n<\/div>\n<div>\n\t<p><label for=\"your-email\">Your Email: *<\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" id=\"your-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n\t<\/p>\n<\/div>\n<div>\n\t<p><label for=\"donor-name-number\">Donor name \/ number: *<\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"donor-name-number\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"donor-name-number\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"donor-name-number\" \/><\/span>\n\t<\/p>\n<\/div>\n<div>\n\t<p><label for=\"method-insemination\">Method of Insemination ( Please choose one) *<\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"method-insemination\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" id=\"method-insemination\" aria-required=\"true\" aria-invalid=\"false\" name=\"method-insemination\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"ICI\">ICI<\/option><option value=\"IUI\">IUI<\/option><option value=\"IVF\">IVF<\/option><\/select><\/span>\n\t<\/p>\n<\/div>\n<div>\n\t<p><label for=\"number-vials\">Number of vials used for insemination: <\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"number-vials\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" id=\"number-vials\" min=\"0\" max=\"50\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"number-vials\" \/><\/span>\n\t<\/p>\n<\/div>\n<div>\n\t<p><label for=\"insemination-cycles\">How many insemination cycles were performed? <\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"insemination-cycles\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" id=\"insemination-cycles\" min=\"0\" max=\"50\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"insemination-cycles\" \/><\/span>\n\t<\/p>\n<\/div>\n<div>\n\t<p><label for=\"conception-date-1\">Estimated Date of conception: * <\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"conception-date-1\"><select class=\"wpcf7-form-control wpcf7-select\" id=\"conception-date-1\" aria-invalid=\"false\" name=\"conception-date-1\"><option value=\"1\">1<\/option><option value=\"2\">2<\/option><option value=\"3\">3<\/option><option value=\"4\">4<\/option><option value=\"5\">5<\/option><option value=\"6\">6<\/option><option value=\"7\">7<\/option><option value=\"8\">8<\/option><option value=\"9\">9<\/option><option value=\"10\">10<\/option><option value=\"11\">11<\/option><option value=\"12\">12<\/option><option value=\"13\">13<\/option><option value=\"14\">14<\/option><option value=\"15\">15<\/option><option value=\"16\">16<\/option><option value=\"17\">17<\/option><option value=\"18\">18<\/option><option value=\"19\">19<\/option><option value=\"20\">20<\/option><option value=\"21\">21<\/option><option value=\"22\">22<\/option><option value=\"22\">22<\/option><option value=\"23\">23<\/option><option value=\"24\">24<\/option><option value=\"25\">25<\/option><option value=\"26\">26<\/option><option value=\"27\">27<\/option><option value=\"28\">28<\/option><option value=\"29\">29<\/option><option value=\"30\">30<\/option><option value=\"31\">31<\/option><\/select><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"conception-date-2\"><select class=\"wpcf7-form-control wpcf7-select\" id=\"conception-date-2\" aria-invalid=\"false\" name=\"conception-date-2\"><option value=\"January\">January<\/option><option value=\"February\">February<\/option><option value=\"March\">March<\/option><option value=\"April\">April<\/option><option value=\"May\">May<\/option><option value=\"June\">June<\/option><option value=\"July\">July<\/option><option value=\"August\">August<\/option><option value=\"September\">September<\/option><option value=\"October\">October<\/option><option value=\"November\">November<\/option><option value=\"December\">December<\/option><\/select><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"conception-date-3\"><select class=\"wpcf7-form-control wpcf7-select\" id=\"conception-date-3\" aria-invalid=\"false\" name=\"conception-date-3\"><option value=\"2009\">2009<\/option><option value=\"2010\">2010<\/option><option value=\"2011\">2011<\/option><option value=\"2012\">2012<\/option><option value=\"2013\">2013<\/option><option value=\"2014\">2014<\/option><option value=\"2015\">2015<\/option><option value=\"2016\">2016<\/option><option value=\"2017\">2017<\/option><option value=\"2018\">2018<\/option><option value=\"2019\">2019<\/option><option value=\"2020\">2020<\/option><option value=\"2021\">2021<\/option><option value=\"2022\">2022<\/option><option value=\"2023\">2023<\/option><option value=\"2024\">2024<\/option><option value=\"2025\">2025<\/option><\/select><\/span>\n\t<\/p>\n<\/div>\n<div>\n\t<p><label for=\"due-date\">Due Date \/ Delivery Date: * <\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"due-date-1\"><select class=\"wpcf7-form-control wpcf7-select\" id=\"due-date-1\" aria-invalid=\"false\" name=\"due-date-1\"><option value=\"1\">1<\/option><option value=\"2\">2<\/option><option value=\"3\">3<\/option><option value=\"4\">4<\/option><option value=\"5\">5<\/option><option value=\"6\">6<\/option><option value=\"7\">7<\/option><option value=\"8\">8<\/option><option value=\"9\">9<\/option><option value=\"10\">10<\/option><option value=\"11\">11<\/option><option value=\"12\">12<\/option><option value=\"13\">13<\/option><option value=\"14\">14<\/option><option value=\"15\">15<\/option><option value=\"16\">16<\/option><option value=\"17\">17<\/option><option value=\"18\">18<\/option><option value=\"19\">19<\/option><option value=\"20\">20<\/option><option value=\"21\">21<\/option><option value=\"22\">22<\/option><option value=\"22\">22<\/option><option value=\"23\">23<\/option><option value=\"24\">24<\/option><option value=\"25\">25<\/option><option value=\"26\">26<\/option><option value=\"27\">27<\/option><option value=\"28\">28<\/option><option value=\"29\">29<\/option><option value=\"30\">30<\/option><option value=\"31\">31<\/option><\/select><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"due-date-2\"><select class=\"wpcf7-form-control wpcf7-select\" id=\"due-date-2\" aria-invalid=\"false\" name=\"due-date-2\"><option value=\"January\">January<\/option><option value=\"February\">February<\/option><option value=\"March\">March<\/option><option value=\"April\">April<\/option><option value=\"May\">May<\/option><option value=\"June\">June<\/option><option value=\"July\">July<\/option><option value=\"August\">August<\/option><option value=\"September\">September<\/option><option value=\"October\">October<\/option><option value=\"November\">November<\/option><option value=\"December\">December<\/option><\/select><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"due-date-3\"><select class=\"wpcf7-form-control wpcf7-select\" id=\"due-date-3\" aria-invalid=\"false\" name=\"due-date-3\"><option value=\"2009\">2009<\/option><option value=\"2010\">2010<\/option><option value=\"2011\">2011<\/option><option value=\"2012\">2012<\/option><option value=\"2013\">2013<\/option><option value=\"2014\">2014<\/option><option value=\"2015\">2015<\/option><option value=\"2016\">2016<\/option><option value=\"2017\">2017<\/option><option value=\"2018\">2018<\/option><option value=\"2019\">2019<\/option><option value=\"2020\">2020<\/option><option value=\"2021\">2021<\/option><option value=\"2022\">2022<\/option><option value=\"2023\">2023<\/option><option value=\"2024\">2024<\/option><option value=\"2025\">2025<\/option><\/select><\/span>\n\t<\/p>\n<\/div>\n<div class=\"strong\">\n\t<p>Number of Children\n\t<\/p>\n<\/div>\n<div>\n\t<p><label for=\"number-boys\">Number of boys: <\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"number-boys\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" id=\"number-boys\" min=\"0\" max=\"10\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"number-boys\" \/><\/span>\n\t<\/p>\n<\/div>\n<div>\n\t<p><label for=\"number-girls\">Number of girls: <\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"number-girls\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" id=\"number-girls\" min=\"0\" max=\"10\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"number-girls\" \/><\/span>\n\t<\/p>\n<\/div>\n<div>\n\t<p><label for=\"birth-height\">Birth Height (inches): <\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"birth-height\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"birth-height\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"birth-height\" \/><\/span>\n\t<\/p>\n<\/div>\n<div>\n\t<p><label for=\"birth-weight\">Birth Weight (lbs): <\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"birth-weight\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"birth-weight\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"birth-weight\" \/><\/span>\n\t<\/p>\n<\/div>\n<div>\n\t<p><label for=\"name-of-child\">Name of Child: <\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"name-of-child\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"name-of-child\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"name-of-child\" \/><\/span>\n\t<\/p>\n<\/div>\n<div>\n\t<p><label for=\"your-message\">Comments:<\/label>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"your-message\" aria-invalid=\"false\" name=\"your-message\"><\/textarea><\/span>\n\t<\/p>\n<\/div>\n<div>\n\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n\t<\/p>\n<\/div><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"76\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<input type=\"hidden\" name=\"trp-form-language\" value=\"fr\"\/><\/form>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Thank you for completing our pregnancy and birth report form. Please return to this page with any updates regarding your pregnancy. The information you provide is kept strictly confidential.\u252c\u00e1This report will only be used to record children born from a particular donor, and to track for the purpose of birth limits. If you have any&#8230;  <a class=\"excerpt-read-more\" href=\"https:\/\/www.seattlespermbank.ca\/fr\/services\/pregnancy-reporting\/\" title=\"ReadPregnancy and Birth Reporting\">Read more &raquo;<\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":13,"menu_order":0,"comment_status":"closed","ping_status":"open","template":"","meta":{"footnotes":""},"class_list":["post-301","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.seattlespermbank.ca\/fr\/wp-json\/wp\/v2\/pages\/301","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.seattlespermbank.ca\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.seattlespermbank.ca\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.seattlespermbank.ca\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.seattlespermbank.ca\/fr\/wp-json\/wp\/v2\/comments?post=301"}],"version-history":[{"count":0,"href":"https:\/\/www.seattlespermbank.ca\/fr\/wp-json\/wp\/v2\/pages\/301\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/www.seattlespermbank.ca\/fr\/wp-json\/wp\/v2\/pages\/13"}],"wp:attachment":[{"href":"https:\/\/www.seattlespermbank.ca\/fr\/wp-json\/wp\/v2\/media?parent=301"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}