Physical
|
Height:
6'0"
(182 cm) |
Weight:
158 lb
(71 kg) |
Eye Color:
Brown
|
Hair:
Brown/
Wavy |
Skin Tone:
Medium Light
|
Ancestry:
Multi
|
|
Blood Type:
O+
|
Ethnic Background:
English/Mexican
|
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|
Education:
AA/General Studies
|
Occupation:
Warehouse Worker
|
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|
Interests:
|
Hiking, Skateboarding, Soccer, Video games
|
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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 | 58 |
| 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 | 56 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Brothers
Your Brother 1
| Question | Response |
| Current age or age at death | 32 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Brother 2
| Question | Response |
| Current age or age at death | 28 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Sisters
Your Sister 1
| Question | Response |
| Current age or age at death | 26 |
| 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 | Disease caused by work-related asbestos exposure |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
No other diagnosed health problems at time of death
Your Mother's Mother
| Question | Response |
| Current age or age at death | 74 |
| 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 | 54 |
| 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 | 89 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart failure |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
No other diagnosed health problems at time of death
Your Father's Mother
| Question | Response |
| Current age or age at death | 74 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Diabetes |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Diabetes mellitus not requiring insulin therapy
60
Metformin
Your Father's Sisters 1
| Question | Response |
| Current age or age at death | 62 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Sisters 2
| 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 Sisters 3
| Question | Response |
| Current age or age at death | 47 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Accidental Death |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
No diagnosed health problems at time of death
Your Father's Sisters 4
| Question | Response |
| Current age or age at death | 39 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Accidental Death |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
No diagnosed health problems at time of death
Your Father's Brothers 1
| Question | Response |
| Current age or age at death | 69 |
| 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 | 68 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Brothers 3
| 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
Healthy
Your Father's Brothers 4
| 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
Healthy
Your Father's Brothers 5
| Question | Response |
| Current age or age at death | 44 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Accidental Death |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
No diagnosed health problems at time of death
Your Father's Brothers 6
| Question | Response |
| Current age or age at death | 42 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Accidental Death |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
No diagnosed health problems at time of death
Religion:
| Faith | Other |
| Denomination | Agnostic |
Updates to Profile
| Update Available | N/A |
| Updates - Personal | N/A |
| Updates - Medical | April 2025 update: Birth reported with TUBB3 variant. Potential risk of recurrence being investigated. Child also both with DOCK6 variant. Carrier screening on donor TBD. Carrier screening for DOCK6 on clients may be recommended. May 2025 As it relates to the April 2025 update: The egg source, not sperm source, was deteremined to carry the DOCK6 variant. The sperm source was not identified to carry the TUBB3 variant either. It is believed that the TUBB3 variant in the child was most likely a new (de novo) variant, though it is possible the variant was inherited from the egg source. |
| Updates - Family Medical History | N/A |

Physical
Medical
Family Medical History
Religion
Updates to Profile