Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
5'11"
(180 cm) |
Weight:
180 lb
(81 kg) |
Eye Color:
Hazel
|
Hair:
Brown/
Wavy |
Skin Tone:
Medium Light
|
Ancestry:
Caucasian
|
|
Blood Type:
B+
|
Ethnic Background:
French-German/German
|
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Education:
BA/Theatre Performance
|
Occupation:
Manager
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Interests:
|
Cooking, Reading
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Medical
| Question | Response |
| Have you or any of your family members been diagnosed with alcoholism or drug addiction? If yes, relation and age affected: | No |
| Any dietary restrictions? If yes, explain: | No |
| Do you wear glasses or contact lenses? Are you near or far-sighted? | No |
| Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused: | Yes - Penicillin caused rashes |
| CMV IgG Antibody | Negative |
| CMV IgM Antibody | Negative |
| Note any comments regarding above items: | N/A |
Family Medical HistorySee list of questions asked here
Your Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 48 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 56 | |
| Health Problem | High blood pressure, controlled by diet | 50 |
| Gallbladder removed | 56 | |
| Living / Dead | Living |
Sisters
Your Sister 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 26 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Sister 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 21 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 73 | |
| Health Problem | Heart attack, bypass surgery | 70 |
| Living / Dead | Living |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 72 | |
| Health Problem | Broken wrist | 65 |
| Osteoporosis (due to broken bones), treated with medication | 65 | |
| Living / Dead | Living |
Your Mother's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 35 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 35 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 39 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 4
| Question | Response | Comment/Age Affected |
| Current age or age at death | 45 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 5
| Question | Response | Comment/Age Affected |
| Current age or age at death | 47 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 43 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 40 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 30 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 4
| Question | Response | Comment/Age Affected |
| Current age or age at death | 29 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 75 | |
| Health Problem | Cause of death: Fluid in lungs | 75 |
| Living / Dead | Dead |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 80 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 48 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 58 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 52 | |
| Health Problem | Malfunctioning heart valve- since birth | |
| Heart transplant due to heart failure | 30 | |
| Living / Dead | Living |
Religion:
| Faith | None |
| Denomination | None |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to donor Personal Profile: February 2011, March 2012, February 2013, September 2014, July 2015, June 2016. Update received October 2018: Donor's occupation has changed from Actor to Manager. No change to donor Personal Profile: July 2019, May 2020. |
| Updates - Medical | No change to donor Medical Profile: February 2011, March 2012, February 2013, September 2014, July 2015, June 2016, October 2018, July 2019, May 2020. |
| Updates - Family Medical History | No change to donor Family Medical History: February 2011, March 2012. Update received February 2013: Donor's younger sister was diagnosed at age 26 with ovarian cysts, treated with surgery. Update received September 2014: Maternal uncle #4 has been diagnosed with HIV at age 30, treatment unknown. Update received July 2015: Maternal grandfather died of lung disease at age 76, treatment (if any) unknown; Paternal grandmother has been diagnosed with low WBC count, age not reported, treatment (if any) unknown; Paternal aunt has been diagnosed with arrhythmia, age not reported, treatment (if any) unknown. Update received June 2016: Donor was recently made aware that his paternal uncle #2 was born with an enlarged heart. The condition did not require surgery until age 33, when the uncle received an artificial heart valve. No change to donor Family Medical History: October 2018, July 201. Update received May 2020: Donor's father is now reported to be an alcoholic. |