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Einstein Medical Center Philadelphia, Division of Genetics Phone: (215) 4568722 Fax: (215) 4562356 Cardiac Genetic Counselor: 2154568726, kiosks Einstein.edu The Quick Family History Form, Cardiac
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How to fill out the quick family history

01
Step 1: Gather necessary information such as names, birthdates, and medical history of your immediate family members.
02
Step 2: Start filling out the quick family history form with the information you have collected.
03
Step 3: Provide accurate details about any known medical conditions or diseases that run in your family.
04
Step 4: Include information about any significant illnesses or causes of death among your family members.
05
Step 5: Double-check the completed form for any errors or missing information before submitting it.

Who needs the quick family history?

01
Anyone who wants to have a better understanding of their family's medical history.
02
Individuals planning to have children or starting a family.
03
People who want to assess their risk of certain hereditary conditions or diseases.
04
Medical professionals, especially genetic counselors and doctors, who require accurate family medical history for diagnosis and treatment.
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The quick family history is a report detailing the medical history of an individual's immediate family members.
The quick family history may be required to be filed by individuals seeking medical treatment or participating in certain research studies.
To fill out the quick family history, individuals should gather information about the medical history of their parents, siblings, and children.
The purpose of the quick family history is to provide healthcare providers with important information about potential genetic risks and conditions within a patient's family.
Information about specific diseases, conditions, and age of onset for each immediate family member may need to be reported on the quick family history.
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