| Height: 6' 1" | Weight: 182 # | Hair Color: Light brown |
| Eye Color: Blue/Green | Hair Type: Thick, wavy | Complexion: Fair |
| Race: Caucasian | Mother's
Ethnic Background: Irish, English, ~1/64th Native American
Father's Ethnic Background: Irish, English, German |
|
| Blood Type: O POS | ||
| Alcoholism: | Edema: | Mental disorders: MGM ; F (see below) |
| Allergy: | Emphysema: | Mental retardation: |
| Anemia: | Epilepsy: | Miscarriages: |
| Asthma: | Glaucoma: | Stillbirths: |
| Blindness: | Goiter: | Migraine: |
| Cancer: PGM; MGF (see below) | 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: |
DONOR'S HEARING: Good DONOR'S DENTAL HISTORY: 5 fillings; used to eat a lot of sugar
| EDUCATION: | Subject of study | Type of University |
| Baccalaureate Degree | BS in Industrial Engineering | Large State University |
1. Do you have any special talents?
Excelled at all sports. Started in baseball, basketball, X-country; Hold school record in X-country. Play the piano, and used to play the trumpet. And when it came to video games, I could not be beat. (I grew up in a rural town with nothing better to do.)
2. Are there any special talents that seem to run in your family? (athletics, music, artistic, etc.)Music runs deep in the family. brother plays classical guitar at restaurants & other venues. Dad & Mom play guitar. Mom plays drums. Both Aunts are excellent singers. I play piano. Great, great grandpa was a famous conductor.
3. What are your interests and hobbies?Surfing/Bogie boarding Age 5-present
Piano Age 7-present
Video games Age 5-20
Sports, basketball, football, baseball, soccer, tennis Age 5-present
4. What did you enjoy studying in high school and college?
Sciences, physics, chemistry, biology, girls
5. High School GPA 3.6 College GPA 3.3 I.Q.6. How would you describe your personality characteristics?
Funny; shy at first, but open once knowing a person; considerate of human beings and animals; kindhearted; honest: sometimes too honest; always striving toward some goal.
7. Why do you want to be a sperm donor?My current girl friend is going through egg donation, so I thought I could do the same. the drugs she is on do not allow us to have sex, and the money never hurts.
Additional Descriptive Characteristics:Handedness: Right Foot/Shoe Size: 11 ½
Hairy Chest: Yes Hairy: Yes Beard Color: Light Brown
Any Distinguishing Features (Dimples, Cleft Chin, Roman Nose, Freckles, etc.):Family Social History:
| Education | Occupation | Interests | Eye Color | Hair Color | Height | Body Type | |
| PGF | H.S. | Mill worker | ??Dead at dad's birth | ?? | ?? | ?? | ?? |
| PGM | R.N. | Registered Nurse | Blue | Blonde | 5' 6" | average | |
| MGF | B.S.
Engineering |
Military Engineer | Cars, Sun, Women | Blue | Brown | 6' 4" | slender |
| MGM | H.S. | CNA | Music, cooking, God | Blue | Brown | 5' 5" | average |
| Father | Some college | Mill worker | Computers, makes jewelry, music, golf, video games | Blue | Light brown | 5' 10" | average to slender |
| Mother | Some college | Business owner
Restaurant & salad dressing manufacturer |
Music, dance, drums, gardening, cooking | Brown | Brown | 5' 6' | average to slender |
| Brother | Some college | Cook/musician | Music, awesome at guitar & piano, cooking, computers | Blue | Light brown | 5' 10' | slim |
| Aunt | B.S. Engineering | Environmental engineer | Blue | Light brown | 5' 5" | hour glass | |
| Aunt | Masters in Teaching | Teacher | Blue | Brown | 5' 5' | average to bigger | |
| Uncle | B.S. Engineering | Electrical engineer | Brown | Brown | 6' 5' |
Donor #9887 grew up in a coastal city in Oregon. His parents divorced when he was two- years old. His mother eventually re-married. He has one biological brother. He also grew up with two step-brothers from his step-father. They are the exact same age as he and his brother. He has no contact with his biological father who became a drug abuser following the divorce. His parents run and own a seafood restaurant and also have a food product business. His brother lives in Washington and is a cook. One of his step-brothers is a welder and the other is in college in the east studying to be a writer.
This donor is a light social drinker. He averages about four glasses of wine with dinner per week. When he plays poker he has a couple of mixed drinks. He would be considered to be a light social drinker. He is a non-smoker and does not currently use recreational drugs but did try some in college. He has no family history of alcoholism. He does have a positive family history of mental illness in his family. His grandmother was diagnosed with multiple personality disorder and takes medication for this. He has been told this is due to a sexual assault she suffered as a child. He has had no counseling history other than one time to discuss issues with a girlfriend. He does not suffer from depression. He appears to be a very stable and caring young man. He maintains positive long term relationships with his friends and even resides with a life long good friend from childhood.
Donor #9887 enjoys many activities and they include basketball and golf. He plays golf every week and works one day at a course so he can play for free. He is in very good physical health and works out three or more times per week. He plays the piano and enjoys this very much. He took lessons when he was seven to the age of eleven and then again in college. He occasionally enjoys playing video games and computer games. He also likes spending time with his new girlfriend. He is thinking about buying his first home soon.
Donor #9887 feels very comfortable with being a donor and passing his genes on anonymously. He has no ethical conflict with any aspect of this process. He would like to be an information release donor. He has discussed being a donor with his new girlfriend and she is supportive of his participation. He is a very sweet and engaging man. He describes his personality as very easy going and he appears this way as well. He is a very handsome young man with a gentleness and sensitivity to his personality.
He does not meet all of the ASRM psychological criteria for being a donor with his family history of drug abuse by his father and his grandmother's mental illness. This does not mean that he wouldn't be an excellent donor candidate however, but like many people he has some family members with medical/mental health issues. The criteria for ASRM is that no first degree relatives (father) have a mental health problem. Although it is important for recipients to consider these issues, I found the donor to be very intelligent, well educated, stable, charming, and very responsible. He appears to handle stress well based on his education and job promotions. He has very positive character traits and I recommend him.
Paula Acker LCSW
Summary of the Taylor-Johnson Temperament Analysis:Donor #9887 took the Taylor Johnson Temperament Analysis, which is an assessment of nine different personality traits. He scored in the "excellent" range in four of the nine measurements. In the next range down "acceptable" he scored in three of these personality traits, and the last two he scored in the range of "improvement desirable."
The first "excellent" score was in the measurement of "composed" verses "nervous." A composed individual in this test would be someone who remains calm in many difficult situations, is a clear thinker, and doesn't get overly emotional when they need to be level headed. They are free from excessive worry and are not people that one would consider to be highly anxious. They are not restless, jittery, and do not have nervous habits such as smoking, over eating or over drinking. They are able to problem solve and move through unplanned situations with flexibility.
The second "excellent' score was in the measurement of "active-social" verses "quiet." This indicates a person that finds pleasure in being with friends, co-workers, or family members and enjoys an active lifestyle. They are likely to enjoy group sports, or gathering people together for social reasons. They have vitality and energy and are likely to be involved in many different groups or organizations.
The third "excellent" score was in the measurement of "expressive-responsive" verses "quiet." An expressive person is someone that is able to show their feelings and is open to being affectionate with others. They do not display repressed behavior. They are comfortable in being demonstrative with family and friends, and can show tenderness and sympathy to others. They are warm and considerate people who others are drawn to because of their kindness and caring.
The last excellent score was in the measurement of " dominant" verses "submissive." In this test dominant is a positive trait indicating a person that has leadership abilities, and is self- assurance. This kind of an individual is likely to have influence over others and be able to change others minds through conversation or debate about his point of view. They are likely firm, definitive, and competitive. They are likely the person in a business that is the owner or president of the company.
The first score in the "acceptable" range was the measurement of "light-hearted" verses "depressive." This indicates a person that is able to balance their moods with their lifestyle and able to get through the difficult situations in life without becoming depressed. This person leans towards being optimistic rather than pessimistic. They likely feel like they belong and are part of the bigger picture of life and know how to reach out to others to get their personal needs met.
The second score in the "acceptable" range was in the measurement of "objective" verses "subjective." This indicates a person that is impartial, and can figure out situations without being excessively critical or sensitive. They are not likely to be overly concerned with doing what is right for one person over another but able instead to think clearly and accurately about the event or situation.
The third score in the "acceptable" range was in the measurement of "self-disciplined" verses "impulsive." This person likely is able to complete tasks on time and without too much difficulty. They are able to set personal and professional goals and meet their goals in a timely way. This would indicate a trait of someone that would be a good student and able to set goals and graduate in their field of study. This also would likely be someone to meet his or her professional goals.
Donor #9887 had just two areas that he scored in the "improvement desirable" range. The first was in the measurement of "sympathetic" verses "indifferent." This may indicate a person that may be slow to recognize the feelings or needs of others. They also may be overly strict with themselves. The other "needs improvement" was in the measurement of "tolerant" verses "hostile." This likely would indicate a person that may be more judgmental of themselves or others and may be likely to be impatient or critical of situations or people due to a defensive attitude.
KID PAGE
1. In general, please describe your childhood.
Out of 4 siblings (one brother, two step-brothers), my mom always says that I was the quietest baby she had known. when I cried it was more of a low pitched murmur. I always remember by Grandma (step-grandma, that is) tell that I was the best and that she'd keep me. We stayed in the same samll town on the coast all through my childhood. My three brothers and I, who all got along relatively well, would have to find fun things to do, like building tree houses and forts where no girls were allowed, and playing sports and other made-up games. Laser tag and hide-n-seek. in the dark were the best. We all started the piano young and fought over the video games.
2. Were there any family members other than your parents and siblings with whom you regularly had contact? My step grandpa used to babysit us and always had us doing ridiculous things like trying to put salt under a wild birds tail, and pulling his finger and then helping him sniff it up. This he never fails to remind us of at every family event.Food(s)? Cereal, pizza, pork fried rice
Color(s)? Blue, black
Toy(s)? Video games, sling shot, BB guns
Indoor game(s)? Hide 'N' Seek in the dark, Pictionary, video games
Outdoor game(s)? Hide 'N' Seek, Kick the can, made-up Olympics on the beach
Book(s)? "Are You My Mother?" "Where The Wild Things Are"
Sport(s)? Every sport, soccer, baseball, football, basketball, tennis, surfing, bogie boarding
Other activity(s)? Billiards, table tennis, piano, fishing, hunting
4. What is your earliest memory?My brother lighting his curtains on fire. I watched him take Dad's lighter to see what would happen if he held it under the drapes. he sat there and watched them burn while I ran to find Mom to tell her that my brother set the house on fire.
5. What did you do during the summers?Played sports, went camping, played in the ocean, went on hikes, all night wideo game sessions, fished in the river nearby, searched for artifacts when the tide was low. Helped out in the restaurant. Got sold as child labor in the restaurant.
6. Are there any "new" technologies you remember becoming available during your childhood which now are commonplace in our society, or which have now been replaced by a newer technology?I remember being the first kid in town to get the Nintendo Entertainment System. It was the coolest thng ever we thought. Now they are in every kid's room, and much more advance.
7. Did you enjoy school as a child? Do you have any memories of teachers that influenced you, or that you especially liked (or disliked)?
I did enjoy school. It was a time to actually hang out with your friends since everything was so spread out. One teacher that I remember being my favorite had a point system where you received a point if you refrained from getting your name on the board. At the end of the month you could redeem points for cool things like candy.
8. Did you have chores or tasks that you were regularly expected to do?Yes. to earn an allowance my brothers and I rotated and did the following house chores:
Dishes, which was the worst
Living room
Bath room
Kitchen
9. Any other recollections of importance that come to mind?My parents split up when I was young, but I was rewarded with the best step-dad ever...someone that's done everything and gave the best guidance one could ask for.