Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
|
Height:
5'10"
(177 cm) |
Weight:
206 lb
(93 kg) |
Eye Color:
Blue
|
Hair:
Brown/
Straight |
Skin Tone:
Medium
|
Ancestry:
Caucasian
|
|
Blood Type:
B+
|
Ethnic Background:
German/German-Polish
|
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|
Education:
BS/Economics
|
Occupation:
Banker
|
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|
Interests:
|
Golf, Weight training
|
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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: | Yes - Maternal grandfather, ages 30-45 (recovered with treatment) |
| 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 | 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 | 59 | |
| Health Problem | Ovarian cyst, treated with surgery | 39 |
| Migraines, controlled with over-the-counter medication | 42 | |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 61 | |
| Health Problem | High blood pressure, controlled with medication and diet modifications | 55 |
| Living / Dead | Living |
Sisters
Your Sister 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 33 | |
| Health Problem | Depression, treated with therapy | 15 |
| Obese, no treatment, following two pregnancies | 27 | |
| Ulcers, controlled with medication | 30 | |
| Living / Dead | Living |
Sons
Your Son 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 5 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Daughters
Your Daughter 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 2 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 87 | |
| Health Problem | Alcoholic, recovered with treatment | 30 |
| Heart attack, no treatment | 87 | |
| Cause of death: Heart attack | 87 | |
| Living / Dead | Dead |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 72 | |
| Health Problem | Lung cancer (smoker), attempted treatment with chemotherapy and radiation | 72 |
| Cause of death: Lung cancer | 72 | |
| Living / Dead | Dead |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 62 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 38 | |
| Health Problem | Healthy | |
| Severe trauma due to plane crash, no treatment | 38 | |
| Cause of death: Severe trauma | 38 | |
| Living / Dead | Dead |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 67 | |
| Health Problem | Lung cancer (smoker), no treatment | 65 |
| Cause of death: Lung cancer | 67 | |
| Living / Dead | Dead |
Your Father's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 59 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 57 | |
| Health Problem | Multiple sclerosis, mildly affected, controlled with medication | 26 |
| Miscarriage, due to MS, no treatment | 27 | |
| Miscarriage, due to MS, no treatment, two successful pregnancies following | 28 | |
| Living / Dead | Living |
Your Father's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 55 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Religion:
| Faith | Christian |
| Denomination | Greek Orthodox (conversion) |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to donor Personal Profile: November 2019, August 2020. |
| Updates - Medical | No change to donor Medical History: November 2019, August 2020. |
| Updates - Family Medical History | No change to donor Family Medical History: November 2019, August 2020. |