Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
6'1"
(185 cm) |
Weight:
241 lb
(109 kg) |
Eye Color:
Blue
|
Hair:
Blond/
Straight |
Skin Tone:
Light
|
Ancestry:
Caucasian
|
|
Blood Type:
O+
|
Ethnic Background:
English-Native American/Danish-European
|
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|
Education:
AAS/Collision Repair
|
Occupation:
Mechanic
|
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Interests:
|
Auto repair, Individual Sports
|
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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? | Yes - Astigmatism |
| Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused: | No |
| 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 |
| Current age or age at death | 49 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father
| Question | Response |
| Current age or age at death | 44 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Brain tumor |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Brain tumor
44
Hospitalization
Sisters
Your Sister 1
| Question | Response |
| Current age or age at death | 22 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Father
| Question | Response |
| Current age or age at death | 77 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Stroke |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Stroke
77
None, fatal
Your Mother's Mother
| Question | Response |
| Current age or age at death | 72 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Stroke |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Stroke
72
Hospice care
Your Mother's Sisters 1
| Question | Response |
| Current age or age at death | 54 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Sisters 2
| Question | Response |
| Current age or age at death | 48 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Brothers 1
| Question | Response |
| Current age or age at death | 60 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Father
| Question | Response |
| Current age or age at death | 67 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Diabetes |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Diabetes
67
Insulin
Your Father's Mother
| Question | Response |
| Current age or age at death | 75 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart disease |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Heart disease
75
Medication
Your Father's Brothers 1
| 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
Healthy
Your Father's Brothers 2
| Question | Response |
| Current age or age at death | 54 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Diabetes
35
Insulin
Your Father's Brothers 3
| Question | Response |
| Current age or age at death | 51 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Diabetes
48
Insulin
Religion:
| Faith | Christian |
| Denomination | Non denominational |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to donor Personal Profile: September 2022. |
| Updates - Medical | Update received April 2021: Donor underwent Lasik surgery. Update received September 2022: Donor was diagnosed with diabetes at age 26, treated with Metformin. |
| Updates - Family Medical History | No change to donor Family Medical History: September 2022. |