Get the free Myriad Cancer Family History Questionnaire PMRC Approved 110312.docx

CANCER FAMILY HISTORY QUESTIONNAIRE Personal Information Patient Name: Date of Birth: Age: Gender (M×F): Today s Date×MM/DD×BY): Health Care Provider: Instructions: This is a screening tool for

How to fill out myriad cancer family history

How to fill out myriad cancer family history:

1. Collect information: Start by gathering information about your immediate family members (parents, siblings, and children) and extended family members (grandparents, aunts, uncles, and cousins). Note their names, ages, and any relevant medical conditions or cancers they have had.
2. Use a family tree diagram: Utilize a family tree diagram to visualize the relationships and the presence of cancer within your family. This can be done on paper or using online tools or software specifically designed for family health history.
3. Include important details: When filling out the myriad cancer family history, include important details such as the type of cancer each family member had, their age when diagnosed, and any additional significant information (like if they were tested for specific genetic mutations).
4. Consult medical records: If available, review medical records or documentation of cancer diagnoses within your family. This can help ensure accuracy when filling out the family history and provide more detailed information for healthcare professionals.

Who needs myriad cancer family history:

1. Individuals with a personal history of cancer: People who have been diagnosed with cancer themselves should consider documenting their family history to better understand their own risk factors and potential hereditary links to cancer.
2. Those with a family history of cancer: Individuals who have multiple relatives diagnosed with cancer, especially at an early age or with specific types of cancer, may benefit from filling out a myriad cancer family history. This information can help identify potential genetic factors and inform medical decisions.
3. Healthcare professionals: Medical practitioners, including doctors, genetic counselors, and oncologists, often rely on accurate family health histories when assessing a patient's risk for cancer. Providing a comprehensive myriad cancer family history can aid in personalized risk assessments, screening recommendations, and potential genetic testing options.

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