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This document is a Health History Questionnaire for new patients at the University of Michigan Hospitals & Health Centers, specifically related to cancer genetics. It collects information on past
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How to fill out health history questionnaire
How to fill out Health History Questionnaire - New Patient - Cancer Genetics
01
Gather personal information: Include your name, date of birth, and contact details.
02
List your family history: Note any cancer diagnoses in your family, including the type of cancer and age of diagnosis.
03
Document personal medical history: Include any previous cancer diagnoses, treatment history, and relevant medical conditions.
04
Review medications: List any medications you are currently taking, including supplements and over-the-counter drugs.
05
Provide lifestyle information: Describe your smoking, alcohol use, and exercise habits.
06
Fill in genetic testing history: Mention any previous genetic tests you or your family members have undergone.
07
Be thorough and honest: Ensure all information is accurate and complete to help healthcare providers assess your risk.
Who needs Health History Questionnaire - New Patient - Cancer Genetics?
01
Individuals with a personal or family history of cancer.
02
Patients seeking genetic counseling for hereditary cancer syndromes.
03
New patients referred for cancer genetics evaluation.
04
Those interested in understanding their genetic risk for cancer.
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What is Health History Questionnaire - New Patient - Cancer Genetics?
The Health History Questionnaire - New Patient - Cancer Genetics is a document used to gather comprehensive medical and familial information from a new patient seeking genetic counseling or testing related to cancer.
Who is required to file Health History Questionnaire - New Patient - Cancer Genetics?
New patients who are seeking cancer genetics consultations or testing are required to fill out the Health History Questionnaire.
How to fill out Health History Questionnaire - New Patient - Cancer Genetics?
To fill out the Health History Questionnaire, patients need to provide detailed information about their personal medical history, family health history, and any relevant genetic information. This typically involves answering questions about previous diagnoses, treatments, and family members' health status.
What is the purpose of Health History Questionnaire - New Patient - Cancer Genetics?
The purpose of the Health History Questionnaire is to gather important information that helps healthcare providers assess genetic risk factors for cancer, guide testing decisions, and create individualized patient care plans.
What information must be reported on Health History Questionnaire - New Patient - Cancer Genetics?
Patients must report information including their personal medical history, family medical history regarding cancer or other genetic conditions, and details about any previous genetic testing.
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