Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
|
Height:
6'0"
(182 cm) |
Weight:
210 lb
(95 kg) |
Eye Color:
Green
|
Hair:
Brown/
Wavy |
Skin Tone:
Light
|
Ancestry:
Caucasian
|
|
Blood Type:
AB+
|
Ethnic Background:
German-Irish/French Canadian
|
||||
|
Education:
BM/Piano Performance
|
Occupation:
Music Teacher
|
||||
|
Interests:
|
Hiking, Reading, Weightlifting
|
||||
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 - Near-sighted |
| 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 | Comment/Age Affected |
| Current age or age at death | 73 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 71 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Brothers
Your Brother 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 52 | Maternal half brother |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Brother 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 50 | Maternal half brother |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 80 | |
| Health Problem | Emphysema (smoker), treated with palliative care and oxygen | 80 |
| Cause of death: Emphysema | 80 | |
| Living / Dead | Dead |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 78 | |
| Health Problem | Healthy | |
| Cause of death: Heart failure | 78 | |
| Living / Dead | Dead |
Your Mother's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 68 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 65 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 70 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 82 | |
| Health Problem | Healthy | |
| Cause of death: Heart failure | 82 | |
| Living / Dead | Dead |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 84 | |
| Health Problem | Healthy | |
| Cause of death: Heart failure | 84 | |
| Living / Dead | Dead |
Your Father's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 75 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 73 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Religion:
| Faith | Christian |
| Denomination | Lutheran |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to donor Personal Profile: August 2019, May 2020, May 2021, April 2022. |
| Updates - Medical | No change to donor Medical Profile: August 2019, May 2020, May 2021, April 0222. |
| Updates - Family Medical History | No change to donor Family Medical History: August 2019, May 2020, May 2021, April 2022. |