Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
5'9"
(175 cm) |
Weight:
190 lb
(86 kg) |
Eye Color:
Hazel
|
Hair:
Brown/
Straight |
Skin Tone:
Medium Light
|
Ancestry:
Caucasian
|
|
Blood Type:
O-
|
Ethnic Background:
Irish-Italian/Italian-Jewish-German
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Education:
BA/Business Administration
|
Occupation:
VP of Business Development
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Interests:
|
Cooking, Dance, Guitar, Music, Running, Sports, Travel
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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: | No |
| CMV IgG Antibody | Positive |
| CMV IgM Antibody | Negative |
| Note any comments regarding above items: | N/A |
Family Medical HistorySee list of questions asked here
Your Mother
| Question | Response |
| Current age or age at death | 56 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Healthy
N/A
Your Father
| Question | Response |
| Current age or age at death | 58 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Healthy
N/A
Brothers
Your Brother 1
| Question | Response |
| Current age or age at death | 30 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Healthy
N/A
Your Mother's Father
| Question | Response |
| Current age or age at death | 75 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Complications of heart transplant, heart attack |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Throat cancer
40
Surgery
Heart disease
74
Transplant
Heart attack, due to blood clot one week after transplant
75
N/A
Your Mother's Mother
| Question | Response |
| Current age or age at death | 85 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Healthy
N/A
Your Mother's Brothers 1
| Question | Response |
| Current age or age at death | 50 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart attack |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Diabetes mellitus
30
Insulin
Heart attack
48
Stent
Heart attack, fatal
50
None
Your Father's Father
| Question | Response |
| Current age or age at death | 82 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Organ failure |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Respiratory problems in his 70s (smoker)
70
Oxygen
Kidney stones
75
Medication
Your Father's Mother
| Question | Response |
| Current age or age at death | 84 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart failure |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Alzheimer's
82
Medication
Your Father's Sisters 1
| Question | Response |
| Current age or age at death | 64 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Healthy
N/A
Your Father's Brothers 1
| Question | Response |
| Current age or age at death | 66 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Healthy
N/A
Religion:
| Faith | Christian |
| Denomination | Catholic |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to profile: September 2020, July 2021, June 2022, May 2023. |
| Updates - Medical | No change to profile: September 2020, July 2021, June 2022, May 2023. |
| Updates - Family Medical History | No change to profile: September 2020, July 2021, June 2022. Updated received May 2023: Maternal Grandmother has died at age 89 due to cardiac arrest. |