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Spanish Translation

Your Family Medical History

Overview

Health problems sometimes run in the family. That's why it's important to know as much as you can about the health problems of your birth family. This information can help your doctor provide better care.

Start with what you know. Then ask your parents or other relatives for more information. It's a good idea to update this chart every year or so. Take a copy with you every time you see a new doctor. He or she can keep it in your file.

Family medical history

Family member

Name

Health problems. (Include approximate age when problem started or occurred.)

If no longer living, cause of death. (Include the age at death.)

My mother


My father

My sisters and brothers









Mother's mother

Mother's father

Father's mother

Father's father

Others




Credits

Current as of: July 31, 2024

Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Current as of: July 31, 2024

Author: Ignite Healthwise, LLC Staff

Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

This information does not replace the advice of a doctor. Ignite Healthwise, LLC, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.