Physical
Height:
5'9"
(175 cm) |
Weight:
183 lb
(83 kg) |
Eye Color:
Blue
|
Hair:
Blond/
Straight |
Skin Tone:
Light
|
Ancestry:
Caucasian
|
Blood Type:
A+
|
Ethnic Background:
English-Norwegian/Swiss-Welsh
|
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Education:
AA/Psychology
|
Occupation:
Counselor/Construction worker
|
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Interests:
|
Basketball, Cooking, Drums, Hiking, Trumpet
|
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 | 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 |
Current age or age at death | 59 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father
Question | Response |
Current age or age at death | 68 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Brothers
Your Brother 1
Question | Response |
Current age or age at death | 40 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Brother 2
Question | Response |
Current age or age at death | 38 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Sons
Your Son 1
Question | Response |
Current age or age at death | 9 |
Living / Dead | Living |
Health Problems
Healthy
Daughters
Your Daughter 1
Question | Response |
Current age or age at death | 12 |
Living / Dead | Living |
Health Problems
Healthy
Your Mother's Father
Question | Response |
Current age or age at death | 65 |
Living / Dead | Dead |
Cause of death and any treatment prior to death | Stroke |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Respiratory problem (smoker)
65
Surgery
Stroke, during surgery
65
N/A
Your Mother's Mother
Question | Response |
Current age or age at death | 89 |
Living / Dead | Dead |
Cause of death and any treatment prior to death | Natural causes |
Health Problems
Healthy
Your Mother's Sisters 1
Question | Response |
Current age or age at death | 54 |
Living / Dead | Dead |
Cause of death and any treatment prior to death | Cancer |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Metastatic breast cancer, in her 40s
Various, specifics unknown
Bone cancer, around age 50
Various, specifics unknown
Your Mother's Sisters 2
Question | Response |
Current age or age at death | 57 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Sisters 3
Question | Response |
Current age or age at death | 50 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Brothers 1
Question | Response |
Current age or age at death | 67 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Brothers 2
Question | Response |
Current age or age at death | 64 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Brothers 3
Question | Response |
Current age or age at death | 52 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Father
Question | Response |
Current age or age at death | 86 |
Living / Dead | Dead |
Cause of death and any treatment prior to death | Natural causes |
Health Problems
Healthy
Your Father's Mother
Question | Response |
Current age or age at death | 87 |
Living / Dead | Dead |
Cause of death and any treatment prior to death | Heart failure |
Health Problems
Healthy
Your Father's Sisters 1
Question | Response |
Current age or age at death | 73 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Brothers 1
Question | Response |
Current age or age at death | 72 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Religion:
Faith | None |
Denomination | N/A |
Updates to Profile
Update Available | Yes |
Updates - Personal | No change to profile: July 2020. Update receveid October 2020: Donor has started working in construction while his counseling job is on hold. |
Updates - Medical | No change to profile: July 2020. |
Updates - Family Medical History | No change to profile: July 2020. |