Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
|
Height:
6'0"
(182 cm) |
Weight:
155 lb
(70 kg) |
Eye Color:
Hazel
|
Hair:
Black/
Wavy |
Skin Tone:
Medium Light
|
Ancestry:
Caucasian
|
|
Blood Type:
B+
|
Ethnic Background:
Irish-Italian/Polish-German
|
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|
Education:
EdD Education
|
Occupation:
Recreation Supervisor
|
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|
Interests:
|
Drums, Guitar, Kayaking, Rafting, RockClimbing, Yoga
|
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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 | 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 |
| Current age or age at death | 63 |
| 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 | 67 |
| 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 | 36 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Sister 2
| Question | Response |
| Current age or age at death | 32 |
| 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 | 82 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Fall |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Injury from fall
82
No treatment
Your Mother's Mother
| Question | Response |
| Current age or age at death | 89 |
| 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 | 65 |
| 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 | 65 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Parkinson's Disease |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Parkinson's Disease
60
None
Your Father's Mother
| Question | Response |
| Current age or age at death | 89 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart Attack |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Heart Disease
89
None
Your Father's Sisters 1
| Question | Response |
| Current age or age at death | 78 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Sisters 2
| Question | Response |
| Current age or age at death | 63 |
| 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 | 69 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Religion:
| Faith | Other |
| Denomination | Agnostic |
Updates to Profile
| Update Available | N/A |
| Updates - Personal | No change to donor Personal Profile: July 2022, July 2023. |
| Updates - Medical | No change to donor Medical Profile: July 2022, July 2023. |
| Updates - Family Medical History | No change to donor Family Medical History: July 2022, July 2023. |