Physical
Height:
5'10"
(177 cm) |
Weight:
172 lb
(78 kg) |
Eye Color:
Blue
|
Hair:
Brown/
Straight |
Skin Tone:
Light
|
Ancestry:
Caucasian
|
Blood Type:
B+
|
Ethnic Background:
Norwegian/Irish-Norwegian
|
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Education:
AA/Kinesiology
|
Occupation:
IT Service Senior Analyst
|
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Interests:
|
Board games, Magic Card Tricks, Origami, Running
|
Medical
Question | Response |
Have you or any of your family members been diagnosed with alcoholism or drug addiction? If yes, relation and age affected: | Yes - Paternal uncle #2, age 35 (undergoing recovery) |
Any dietary restrictions? If yes, explain: | No |
Do you wear glasses or contact lenses? Are you near or far-sighted? | Yes - Near-sighted |
Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused: | Yes - Pollens: Cause runny nose, itchy eyes |
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 | 50 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father
Question | Response | Comment/Age Affected |
Current age or age at death | 53 | |
Health Problem | Healthy | |
Living / Dead | Living |
Brothers
Your Brother 1
Question | Response | Comment/Age Affected |
Current age or age at death | 23 | (Paternal half brother) |
Health Problem | Healthy | |
Living / Dead | Living |
Your Brother 2
Question | Response | Comment/Age Affected |
Current age or age at death | 12 | (Paternal half brother) |
Health Problem | Healthy | |
Living / Dead | Living |
Sisters
Your Sister 1
Question | Response | Comment/Age Affected |
Current age or age at death | 11 | (Paternal half sister) |
Health Problem | Brain damage due to lack of oxygen at birth | |
Living / Dead | Living |
Your Mother's Father
Question | Response | Comment/Age Affected |
Current age or age at death | 79 | |
Health Problem | Heart attack, no treatment | 79 |
Living / Dead | Living |
Your Mother's Mother
Question | Response | Comment/Age Affected |
Current age or age at death | 68 | |
Health Problem | Diabetes mellitus not requiring insulin therapy, controlled with diet modifications | 58 |
Heart attack, no treatment | 68 | |
Stroke, no treatment | 68 | |
Cause of death: Stroke | 68 | |
Living / Dead | Dead |
Your Mother's Sisters 1
Question | Response | Comment/Age Affected |
Current age or age at death | 55 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Father
Question | Response | Comment/Age Affected |
Current age or age at death | 76 | |
Health Problem | Osteoarthritis, controlled with over-the-counter medication | 70 |
Living / Dead | Living |
Your Father's Mother
Question | Response | Comment/Age Affected |
Current age or age at death | 74 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Sisters 1
Question | Response | Comment/Age Affected |
Current age or age at death | 61 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Sisters 2
Question | Response | Comment/Age Affected |
Current age or age at death | 58 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Sisters 3
Question | Response | Comment/Age Affected |
Current age or age at death | 55 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Sisters 4
Question | Response | Comment/Age Affected |
Current age or age at death | 53 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Sisters 5
Question | Response | Comment/Age Affected |
Current age or age at death | 50 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Sisters 6
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 | 49 | |
Health Problem | Autism, no treatment | 2 |
Heart failure, no treatment | 49 | |
Cause of death: Heart failure | 49 | |
Living / Dead | Dead |
Your Father's Brothers 2
Question | Response | Comment/Age Affected |
Current age or age at death | 63 | |
Health Problem | Obesity, no treatment | 30 |
Alcoholism, currently recovering | 35 | |
High blood pressure, controlled with diet modification | 51 | |
High cholesterol, controlled with medication | 51 | |
Stroke, no treatment | 57 | |
Living / Dead | Living |
Your Father's Brothers 3
Question | Response | Comment/Age Affected |
Current age or age at death | 59 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 4
Question | Response | Comment/Age Affected |
Current age or age at death | 56 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 5
Question | Response | Comment/Age Affected |
Current age or age at death | 49 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 6
Question | Response | Comment/Age Affected |
Current age or age at death | 46 | |
Health Problem | Healthy | |
Living / Dead | Living |
Religion:
Faith | None |
Denomination | Atheist |
Updates to Profile
Update Available | Yes |
Updates - Personal | No change to donor Personal Profile: November 2018. Update received August 2019: Occupation has been changed fom Fitness Director to IT Service Senior Analyst. No change to profile: May 2020. Update received August 2022: Occupation has changed to IT Service Desk Training Facilitator. |
Updates - Medical | No change to donor Medical Profile: November 2018, August 2019, May 2020, August 2022. |
Updates - Family Medical History | No change to donor Family Medical History: November 2018, August 2019, May 2020, August 2022. |