Physical
Height:
6'2"
(187 cm) |
Weight:
150 lb
(68 kg) |
Eye Color:
Green
|
Hair:
Brown/
Wavy |
Skin Tone:
Medium
|
Ancestry:
Multi
|
Blood Type:
AB+
|
Ethnic Background:
German-Swiss/Fr. Canadian (Cajun)-Mexican
|
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Education:
Certified Personal Trainer
|
Occupation:
Personal Trainer
|
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Interests:
|
Muay Thai, Rugby, Wrestling
|
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 | 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 | 42 | |
Health Problem | Scoliosis, mild, no treatment necessary, does not affect physical activity | |
Living / Dead | Living |
Your Father
Question | Response | Comment/Age Affected |
Current age or age at death | 41 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Father
Question | Response | Comment/Age Affected |
Current age or age at death | 72 | |
Health Problem | High cholesterol, treated with medication | 60 |
Cataracts, no treatment | 72 | |
Ruptured disc, no treatment, followed by rapid decline in health | 72 | |
Cause of death: Heart failure | 72 | |
Living / Dead | Dead |
Your Mother's Mother
Question | Response | Comment/Age Affected |
Current age or age at death | 70 | |
Health Problem | High cholesterol, treated with medication | 60 |
Type II diabetes, treats with insulin | 65 | |
Chronic obstructive pulmonary disease, treats with sleep mask | 65 | |
Living / Dead | Living |
Your Father's Father
Question | Response | Comment/Age Affected |
Current age or age at death | 72 | |
Health Problem | Dementia, treated in assisted care | 71 |
Living / Dead | Living |
Your Father's Mother
Question | Response | Comment/Age Affected |
Current age or age at death | 64 | |
Health Problem | Smoking-related lung disease (unsure if it was COPD or emphysema), treated with oxygen | 55 |
Cause of death: Complications of lung disease | 64 | |
Living / Dead | Dead |
Your Father's Sisters 1
Question | Response | Comment/Age Affected |
Current age or age at death | 50 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Sisters 2
Question | Response | Comment/Age Affected |
Current age or age at death | 49 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Sisters 3
Question | Response | Comment/Age Affected |
Current age or age at death | 47 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Sisters 4
Question | Response | Comment/Age Affected |
Current age or age at death | 45 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 1
Question | Response | Comment/Age Affected |
Current age or age at death | 43 | |
Health Problem | Healthy | |
Living / Dead | Living |
Religion:
Faith | None |
Denomination | Atheist |
Updates to Profile
Update Available | N/A |
Updates - Personal | N/A |
Updates - Medical | N/A |
Updates - Family Medical History | N/A |