Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
6'7"
(200 cm) |
Weight:
206 lb
(93 kg) |
Eye Color:
Blue
|
Hair:
Brown/
Curly |
Skin Tone:
Medium Light
|
Ancestry:
Caucasian
|
|
Blood Type:
O-
|
Ethnic Background:
Norwegian/Italian-Spanish
|
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Education:
BSE/Science and Engineering
|
Occupation:
Student
|
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Interests:
|
Outdoors, Piano, Traveling
|
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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 - But I choose not to eat pork, chicken or red meat |
| 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 | 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 | 60 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 62 | |
| Health Problem | High blood pressure, treats with medication | 50 |
| Living / Dead | Living |
Brothers
Your Brother 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 32 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Brother 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 27 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Sisters
Your Sister 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 34 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 62 | |
| Health Problem | Heart failure (he was a smoker), no treatment | 62 |
| Cause of death: Heart failure | 62 | |
| Living / Dead | Dead |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 82 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 64 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 58 | |
| Health Problem | Type 2 diabetes, treated with insulin | 30 |
| Living / Dead | Living |
Your Mother's Sisters 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 56 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 54 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 75 | |
| Health Problem | Heart failure, no treatment | 75 |
| Cause of death: Heart failure | 75 | |
| Living / Dead | Dead |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 82 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 62 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 59 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Sisters 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 57 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 63 | |
| Health Problem | High blood pressure, treats with medication | 45 |
| Living / Dead | Living |
Your Father's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 58 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 50 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Religion:
| Faith | Christian |
| Denomination | Baptist |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to donor Personal Profile: June 2015, August 2016. |
| Updates - Medical | Update received June 2015: Donor has been diagnosed with astigmatism and now wears eyeglasses. No change to donor Medical Profile: August 2016. |
| Updates - Family Medical History | No change to donor Family Medical History: June 2015, August 2016. |