Family Health History

Family Health History

Knowing your family health history can save your life

Many families have a history of health conditions such as cancer, diabetes, or heart disease.  If there is a history of a particular condition in your family, you may be at greater risk of developing the condition. 

The Virginia Department of Health has developed the Family Health History Form to make it easy for you to collect and record your family’s health information.   Simply download the form, print it out, and fill in the information.  We encourage families to complete a Family Health History on each family member and to share the information with their family physician.

Click here to download the Family Health History form.

Tips on collecting your family health history

Talk it up…

• Talk to a relative with whom you feel comfortable – find out what they know about aunts, uncles, cousins, and grandparents. 
• You can also collect health information on close family members by talking at family gatherings.

Write it down...

• Write down health problems that you and your family members have had and the age the problems began.
• If someone has died, write down why they died and their age of death.

Pass it on…

• Share this information with other family members and with your doctor.

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