Oregon Health & Science University             PROFILE FOR SPERM DONOR     #9211
Andrology/Embryology Lab
1750 SW Harbor Way, Suite 100
Portland, OR 97201-5164
Phone: (503) 418-3750

PHYSICAL CHARACTERISTICS
Height: 6' 0" Weight: 185 Hair Color: Blond
Eye Color: Brown Hair Type: Straight Complexion: Fair
Race: Caucasian Mother's Ethnic Background: German
Father's Ethnic Background: German
Blood Type: A +

FAMILY AND MEDICAL HISTORY
For each item below, if there is a history of the condition, the condition poses a risk of one percent or less to offspring.
The family relationship is indicated.
Alcoholism: Edema: Mental disorders:
Allergy: Emphysema: Mental retardation:
Anemia: Epilepsy: Miscarriages:
Asthma: Glaucoma: Stillbirths:
Blindness: Goiter: Migraine:
Cancer: Gout: Muscular dystrophy:
Cataracts: Heart attack: Myasthenia gravis:
Cirrhosis: Heart disease: Paraplegia:
Cleft palate or lip: Hemophilia: Parkinson's:
Club foot: Hermaphroditism: Psoriasis:
Color blindness: Hernia, inguinal: Sickle cell anemia:
Cystic fibrosis: Huntington's chorea: Tay Sachs disease:
Deafness: Hypertension: Thalassemia:
Diabetes: Jaundice: Undescended testicles:
Dislocated hip: Juvenile arthritis:
Eczema: Lymphedema:

ABBREVIATIONS: M=Mother, or Maternal S=Sibling F,P=Father, or Paternal
N=Nephew or Niece GF, GM=Grandfather, Grandmother
A=Aunt U=Uncle C=Cousin

MEDICAL HISTORY COMMENTS: No history of any of the above.
 
EDUCATION: Subject of study Location of University Type of University
> 1 year college
Baccalaureate Degree Finance Oregon large state university
Master's Degree
Professional Degree

OCCUPATION: Systems Network Engineer

STATE OF BIRTH: Oregon     YEAR OF BIRTH: 1971     RELIGION: N/A

Social History:

1. Do you have any special talents?

Very musical and athletic. Made all-conference in high school for Oregon.
 

2. Are there any special talents that seem to run in your family? (athletics, music, artistic, etc.)

Both sides of family very athletic. Uncles played sports in college and high school.
 

3. What are your interests and hobbies?

Golf: playing in tournaments.

Olympic Weight Lifting: about 3 years.

Computers: for 6 to 7 years.

Music: percussion and piano; instructing: 10 years.
 

4. What did you enjoy studying in high school and college?

Finance, economics, learning how money creates money.
 

5. High School GPA 3.5 College GPA 3.25 I.Q.
 

6. How would you describe your personality characteristics?

Have a sense of humor, with a sense of stubborn nature. More of a leader than a follower. Considerate of others but take charge. Very competitive, do not like to lose.
 

7. Undergraduate major: Finance

Graduate major:
 

Additional Descriptive Characteristics:
 

Handedness: Foot/Shoe Size:
 

Hairy Chest: Hairy: Beard Color:
 

Any Distinguishing Features (Dimples, Cleft Chin, Roman Nose, Freckles, etc.):
 

Acne problems:
 

Reactivity/Sensitivity to sun exposure:
 

Do you smoke?

No

Family Social History:
Education Occupation Interests
PGF high school manager of Onion Shed retirement
PGM high school secretary retirement
MGF high school post master retirement traveling
MGM college high school teacher retirement traveling
Father college owns many farming businesses farming
Mother AA employed at Boeing crocheting
Cousin college head pro/golf golfing
Cousin college club pro/golf golfing
Aunt college stock broker social events
Aunt college instructor for Boeing Athletic Club fitness
Aunt high school owns decorating business fashion design
Uncle college nurse for ICU children
Uncle college manager of Onion Shed golfing
Uncle college programmer for Boeing Space Center new horse