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Date .........................................FAMILY HISTORY Questionnaire have received a referral to the genetics clinic. It would be helpful to gather some more information about the family before
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How to fill out generic family history form

01
Gather information about your immediate family members including parents, siblings, and children.
02
Note down any medical conditions, diseases, or chronic illnesses that run in your family.
03
Include details about any major surgeries or hospitalizations that your family members have had.
04
Specify if any family members have passed away and the cause of death if known.
05
Provide information about any medications that family members are currently taking.
06
Fill out the form accurately and completely, making sure to include dates and specific details.

Who needs generic family history form?

01
Individuals who are seeking medical treatment and want to provide their healthcare provider with a comprehensive overview of their family's medical history.
02
Those who are applying for life insurance or participating in a research study may also be required to fill out a generic family history form.

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The generic family history form is a document used to collect information about the health history of a person's family members.
Individuals who are seeking medical treatment or participating in medical research may be required to file a generic family history form.
To fill out a generic family history form, you will need to provide information about your family members' health history, including any known medical conditions or genetic disorders.
The purpose of a generic family history form is to help healthcare providers assess a person's risk for certain medical conditions based on their family's health history.
Information such as family members' medical history, genetic disorders, chronic illnesses, and any known hereditary conditions must be reported on a generic family history form.
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