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The form does not have to be complete but every piece of information helps. Include at least 3 generations of family members, if possible, to provide your doctors the most complete picture of your family’s medical history.
One of the best ways to identify people at risk for inheritable disorders, the use of a family medical history form is crucial. The most basic type of family medical history form will ask you questions about you, your parents, your siblings, and your grandparents.
The form covers the patient’s personal medical history, such as diagnoses, medication, allergies, past diseases, therapies, clinical research, and that of their family.
Adult Family History Form. Date ______________ Please complete as much of this form as possible and RETURN it before your next appointment. This information may be useful to your doctor prior to your appointment.
Tools. My Family Health Portrait A free, online family health history collection tool that lets you share family health history information with relatives and assess your risk for certain conditions.
You can document your family history by filling out a family history form provided by your healthcare professional, detailing your immediate, maternal, and paternal family members' health conditions, ages, and other relevant medical information.
Do you or your family members have a history of any disease? Do you want to know what diseases you are at risk of? If yes, a Family Medical History Form is what you need. A person’s family medical history can be a good way to determine what diseases they are at risk of. Why?