Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
|
Height:
6'2"
(187 cm) |
Weight:
193 lb
(87 kg) |
Eye Color:
Green
|
Hair:
Brown/
Straight |
Skin Tone:
Light
|
Ancestry:
Caucasian
|
|
Blood Type:
O+
|
Ethnic Background:
German-Polish/Irish-Swedish
|
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|
Education:
MBA
|
Occupation:
Regional Marketing, Sales
|
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|
Interests:
|
Outdoors, Sports
|
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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: | 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 | 60 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Carpal tunnel syndrome
55
Surgery
Your Father
| 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
Brothers
Your Brother 1
| Question | Response |
| Current age or age at death | 33 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Sisters
Your Sister 1
| Question | Response |
| Current age or age at death | 35 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Father
| Question | Response |
| Current age or age at death | 80 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Respiratory failure |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Respiratory failure (smoker)
80
None
Your Mother's Mother
| Question | Response |
| Current age or age at death | 65 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Complications of scleroderma and Raynaud's disease |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Scleroderma
57
Medication
Raynaud's disease
57
None
Your Mother's Brothers 1
| Question | Response |
| Current age or age at death | 62 |
| 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 | 59 |
| 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 | 82 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Complications of diabetes |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Diabetes requiring insulin therapy
50
N/A
Foot amputation (complication of diabetes)
78
N/A
Your Father's Mother
| Question | Response |
| Current age or age at death | 86 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Influenza |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Influenza
86
N/A
Religion:
| Faith | Other |
| Denomination | Agnostic |
Updates to Profile
| Update Available | N/A |
| Updates - Personal | No change to donor Personal Profile: August 2021. Update received August 2022: Occupation has changed to Fishing Guide. No change to donor Personal Profile: August 2023. |
| Updates - Medical | No change to donor Medical Profile: August 2021, August 2022, August 2023. |
| Updates - Family Medical History | No change to donor Family Medical History: August 2021, August 2022, August 2023. |