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Cancer Survivor
Medical History Form
Background History for the Medical Professional
True North Treks (TNT) courses are backcountry wilderness expeditions for young adult cancer survivors and their
caregivers,
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How to fill out cancer survivor medical history

How to fill out cancer survivor medical history:
01
Start by gathering all relevant medical records and documentation related to your cancer diagnosis and treatment. This can include pathology reports, treatment summaries, and any post-treatment follow-up information.
02
Create a comprehensive timeline of your cancer journey, noting important dates such as the initial diagnosis, surgeries, chemotherapy or radiation treatments, and any subsequent surgeries or treatments.
03
Include detailed information about the type of cancer you had, its stage, and any specific characteristics or subtypes that may be relevant for your medical history.
04
Document any long-term side effects or complications resulting from your cancer or its treatments. This can include issues such as heart or lung problems, fertility concerns, or cognitive difficulties.
05
Provide a list of any medications or treatments you are currently receiving that are related to your cancer or its aftermath. Include the dosage, frequency, and duration of these treatments.
06
Be sure to include information about any lifestyle changes or interventions you have implemented as part of your survivorship, such as dietary modifications, exercise routines, or integrative therapies.
07
Include information about any additional medical conditions or health concerns unrelated to your cancer, as these can impact your overall health and treatment decisions.
08
Keep your cancer survivor medical history updated regularly, both for your own records and to share with your healthcare providers whenever necessary.
Who needs cancer survivor medical history:
01
Oncologists or cancer specialists who are managing your ongoing care and treatment need access to your cancer survivor medical history to make informed decisions about your healthcare.
02
Primary care physicians or general practitioners should also have access to your cancer survivor medical history to ensure comprehensive and coordinated care.
03
Surgeons or other specialists who may need to perform procedures or treatments related to your cancer or its aftermath can benefit from reviewing your medical history.
04
Researchers or clinical trial coordinators may request your cancer survivor medical history if you are participating in research studies or considering clinical trials.
05
Insurance companies or disability programs may require your cancer survivor medical history as part of the application or claims process.
06
In some cases, family members or caregivers may need access to your cancer survivor medical history to understand your healthcare needs or provide support.
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What is cancer survivor medical history?
Cancer survivor medical history is a record of the treatment and health status of individuals who have been diagnosed with cancer and have completed their treatment.
Who is required to file cancer survivor medical history?
Cancer survivors are required to file their medical history.
How to fill out cancer survivor medical history?
Cancer survivors can fill out their medical history by providing information about their diagnosis, treatment, and current health status.
What is the purpose of cancer survivor medical history?
The purpose of cancer survivor medical history is to track the long-term health outcomes of individuals who have been diagnosed with cancer and to inform future treatment decisions.
What information must be reported on cancer survivor medical history?
Information that must be reported on cancer survivor medical history includes details of cancer diagnosis, treatment received, and current health status.
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