Healthwise
To print: Use your web browser's print feature. Close this window after printing.

Your Family Medical History

Table of Contents


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 for Your Family Medical History

Current as of: November 15, 2023

Author: Healthwise Staff (https://www.healthwise.org/specialpages/legal/abouthw/en)
Clinical Review Board (https://www.healthwise.org/specialpages/legal/abouthw/en)
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.


Note: The "printer friendly" document will not contain all the information available in the online document. Some information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

© 1995-2024 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.
This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.