Healthwise

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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: August 2, 2022

Author: Healthwise Staff
Medical Review:
Anne C. Poinier MD - Internal Medicine
Adam Husney MD - Family Medicine

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