Physical
Height:
190 cm
(6'3") |
Weight:
106 kg
(234 lb) |
Eye Color:
Hazel
|
Hair:
Brown/
Straight |
Skin Tone:
Medium Light
|
Ancestry:
Caucasian
|
Blood Type:
O+
|
Ethnic Background:
Italian/German-Irish
|
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Education:
MS/Exercise & Sports Science
|
Occupation:
Teacher/Coach
|
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Interests:
|
Exercise, Music, Sports
|
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 | Comment/Age Affected |
Current age or age at death | 43 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father
Question | Response | Comment/Age Affected |
Current age or age at death | 43 | |
Health Problem | Healthy | |
Living / Dead | Living |
Brothers
Your Brother 1
Question | Response | Comment/Age Affected |
Current age or age at death | 20 | (Half brother) |
Health Problem | Healthy | |
Living / Dead | Living |
Your Brother 2
Question | Response | Comment/Age Affected |
Current age or age at death | 18 | (Half brother) |
Health Problem | Healthy | |
Living / Dead | Living |
Your Brother 3
Question | Response | Comment/Age Affected |
Current age or age at death | 16 | (Half brother) |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Father
Question | Response | Comment/Age Affected |
Current age or age at death | 75 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Mother
Question | Response | Comment/Age Affected |
Current age or age at death | 75 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Sisters 1
Question | Response | Comment/Age Affected |
Current age or age at death | 48 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Sisters 2
Question | Response | Comment/Age Affected |
Current age or age at death | 41 | |
Health Problem | Healthy | |
Acne (treated with over-the-counter remedy) | 14 | |
Living / Dead | Living |
Your Mother's Brothers 1
Question | Response | Comment/Age Affected |
Current age or age at death | 50 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Father
Question | Response | Comment/Age Affected |
Current age or age at death | 65 | |
Health Problem | Heart attack (fatal, no treatment) | 65 |
Cause of death: Heart attack | 65 | |
Living / Dead | Dead |
Your Father's Mother
Question | Response | Comment/Age Affected |
Current age or age at death | 63 | |
Health Problem | Chronic Obstructive Pulmonary Disease (COPD) and emphysema (she was a smoker), treated with oxygen | 63 |
Cause of death: COPD | 63 | |
Living / Dead | Dead |
Your Father's Sisters 1
Question | Response | Comment/Age Affected |
Current age or age at death | 50 | |
Health Problem | Healthy (Twin) | |
Living / Dead | Living |
Your Father's Sisters 2
Question | Response | Comment/Age Affected |
Current age or age at death | 47 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Sisters 3
Question | Response | Comment/Age Affected |
Current age or age at death | 42 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 1
Question | Response | Comment/Age Affected |
Current age or age at death | 52 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 2
Question | Response | Comment/Age Affected |
Current age or age at death | 50 | |
Health Problem | Healthy (Twin) | |
Living / Dead | Living |
Religion:
Faith | Christian |
Denomination | Catholic |
Updates to Profile
Update Available | N/A |
Updates - Personal | N/A |
Updates - Medical | N/A |
Updates - Family Medical History | N/A |