This donor is a healthy carrier for a genetic disease.
Please see his Genetic Testing Summary and Acknowledgment of Genetic Risk for details

Personal Behavior History

Question Response
Current alcohol use:
If yes, oz./week and type of alcohol:
Occasionally - 1 oz./week tequila
Tobacco use: Do you smoke?
If yes, #/day and for how long:
No
If you did smoke but quit, when did you last smoke?N/A
For how many years?N/A
Do you sleep well?Yes
Do you exercise on regular basis?Yes
Is your diet well balanced?
If no, explain:
Yes
Are you a vegetarian?No
Any dietary restrictions?
If yes, explain:
No

Sexual History

Question Response
A partner whose sexual background you are unsure of in the past 12 months?No

Donor Genetic History

Question Response
Do you have a history of a speech disorder; such as a speech impediment, stuttering, delayed speech development, etc.?
If yes, explain:
No
Do you have learning differences, such as dyslexia?
If yes, explain:
No
Were you or any family members born with any birth defects?
If yes, explain:
No

Donor Medical History

Question Response
List any operations:
Age & reason:
Tonsillectomy - Age 12, recommended by doctor
Hospitalization other than surgery:
Age & type of illness:
N/A
Have you ever had any broken bones?
If yes, please give age and description:
Yes - Hairline fracture right pinky toe
Have you ever had any serious illnesses?
If yes, please give age and description:
No
Are you presently under a physician's care for any reason?
If yes, please describe:
No
List all drugs you have taken in past 12 months (prescription, nonprescription, herbal, and sports supplements, and recreational). Include drug, frequency and duration taken, and reason:Whey protein - 3-5 times a week; 6 months; Exercise and Health Benefits
List all current medication or treatments (include vitamins, aspirin, antacids, laxatives, herbal, sports supplements, etc.) Include drug, frequency and duration taken, and reason:Whey protein - 3-5 times a week; 6 months; Exercise and Health Benefits
Do you wear glasses or contact lenses?
Are you near or far-sighted?
No
Birth weight lbs6
Birth weight ozs8
Recent weight loss or gain?
# of lbs and reason:
Yes - Lost 20 lbs, Diet and exercise.
Allergies (medicines, food, pollens)?
If yes, please list substance and reaction caused:
No
How many sexual partners do you currently have?1
Have you ever had a tattoo?Yes
Tattoo#1 Year2016
Tattoo#1 LocationLeft Calf
Tattoo#2 Year2019
Tattoo#2 LocationLeft Ankle
Question Response
Have you ever had your ear(s) or body pierced?No

Family Medical History
See list of questions asked here

Mother's Father Ethnic OriginsVenezuelan
Mother's Mother Ethnic OriginsVenezuelan
Father's Father Ethnic OriginsPeruvian
Father's Mother Ethnic OriginPeruvian
Is anyone in your family of Ashkenazai Jewish Heritage?No
If yes, who?N/A
Question Response
Current age or age at death 64
Living / DeadLiving
Cause of death and any treatment prior to deathN/A
Health Problems
Healthy
Question Response
Current age or age at death 66
Living / DeadLiving
Cause of death and any treatment prior to deathN/A
Health Problems
Healthy
Question Response
Current age or age at death 36
Living / DeadLiving
Cause of death and any treatment prior to deathN/A
Health Problems
Healthy
Question Response
Current age or age at death 3
Living / DeadLiving
Health Problems
Healthy
Question Response
Current age or age at death 40
Living / DeadDead
Cause of death and any treatment prior to deathCar Accident
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
 
No diagnosed health problems at time of death
Question Response
Current age or age at death 81
Living / DeadDead
Cause of death and any treatment prior to deathMultiple Organ Failure resulting from surgical infection.
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
 
Infection from hip surgery became severe and caused organ failure at age 81
Question Response
Current age or age at death 78
Living / DeadDead
Cause of death and any treatment prior to deathKidney Failure, dialysis
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other disease of the kidney, urinary tract, urethra, bladder, ureter
68
Was on dialysis due to smoking, was a heavy smoker.
Question Response
Current age or age at death 86
Living / DeadLiving
Cause of death and any treatment prior to deathN/A
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Stroke
74
IV Medication
Question Response
Current age or age at death 60
Living / DeadLiving
Cause of death and any treatment prior to deathN/A
Health Problems
Healthy
Question Response
Current age or age at death 58
Living / DeadLiving
Cause of death and any treatment prior to deathN/A
Health Problems
Healthy
Question Response
Current age or age at death 61
Living / DeadLiving
Cause of death and any treatment prior to deathN/A
Health Problems
Healthy
Question Response
Current age or age at death 60
Living / DeadLiving
Cause of death and any treatment prior to deathN/A
Health Problems
Healthy