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Family Medical History Patient Name: ___Date: ___Alive or Deceased DOB or Age (current or at time of death Alzheimer\'s DiseaseAsthmaBlood DisorderDepressionDiabetesEpilepsyHeart DiseaseHigh CholesterolHigh
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How to fill out family medical history

01
Gather information about your immediate family members (parents, siblings, and children).
02
Ask about any existing medical conditions, chronic illnesses, or diseases that run in the family.
03
Record the age at which each family member was diagnosed with the condition, if applicable.
04
Include information about any surgeries or hospitalizations related to the medical conditions.
05
Update the family medical history regularly as new information becomes available.

Who needs family medical history?

01
Healthcare providers who are treating the individual and need to understand potential genetic risk factors.
02
Individuals who are concerned about their own health and want to be proactive about preventative care.
03
Individuals who are considering starting a family and want to understand potential hereditary health risks.

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Family medical history is a record of health information regarding a person's close relatives, including parents, siblings, grandparents, and other blood relatives.
Individuals are required to file their own family medical history.
Family medical history can be filled out by collecting information about the health conditions and diseases that run in the family and organizing them in a document or online tool.
The purpose of family medical history is to help identify patterns of health conditions within a family that may increase the risk of certain diseases.
Family medical history should include information on specific health conditions, ages at diagnosis, and any relevant lifestyle factors.
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