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Oregon Health & Science University Knight Cancer Institute Cancer Genetics Family History Questionnaire Updated 10/2/19Instructions: 1) Please list all your blood relatives, (including living and
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How to fill out family history questionnaire
How to fill out family history questionnaire
01
To fill out a family history questionnaire, follow these steps:
02
Start by gathering information about your immediate family members such as your parents and siblings. Include their names, dates of birth, and any relevant medical conditions they have
03
Next, move on to your extended family. Consider including information about your grandparents, aunts, uncles, and cousins. Again, note down their names, dates of birth, and any known medical conditions
04
If possible, try to find out if there are any patterns of diseases or conditions that run in your family. This could be helpful for identifying potential genetic risks
05
Make sure to update the questionnaire regularly as you learn new information or as family members' health status changes
06
Finally, submit the completed questionnaire to the appropriate healthcare provider or organization that requested it
Who needs family history questionnaire?
01
A family history questionnaire is typically needed by individuals who are seeking medical care or undergoing genetic testing. Healthcare providers often ask for this information to assess a patient's risk for certain diseases and to provide personalized care. Additionally, researchers and scientists may also require family history questionnaires for genetic studies or to analyze population health trends.
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What is family history questionnaire?
A family history questionnaire is a tool used to collect information about an individual's family medical history, which can help identify genetic conditions and assess health risks.
Who is required to file family history questionnaire?
Individuals seeking certain types of insurance or participating in specific health programs may be required to file a family history questionnaire.
How to fill out family history questionnaire?
To fill out a family history questionnaire, gather information about your family's health conditions, relationships, and causes of death, and accurately complete each section of the form.
What is the purpose of family history questionnaire?
The purpose of the family history questionnaire is to assess an individual's risk for inherited health conditions and guide preventive measures or treatment options.
What information must be reported on family history questionnaire?
Information such as the health status of immediate family members, any known genetic conditions, age at diagnosis, and any relevant medical treatments must be reported.
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