What is a Family Medical History Form?

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  • Written By: Dee S.
  • Edited By: C. Wilborn
  • Last Modified Date: 29 November 2019
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A family medical history form is used by doctors and medical staff to record personal medical information from patients. Sometimes the form is updated annually, other times it is only filled out when a new doctor-patient relationship is formed. Regardless, it can be one of the best indicators of disease and medical conditions, particularly before the conditions become problematic.

Many diseases are genetic in nature. Generally, a family medical history form inquires into the health of family members, even generations back. For example, if the maternal grandmother of the patient suffered from a form of cancer, the patient would reveal it by checking a box on the form.

Typically, a family medical history form is easy to fill out. The patient simply checks a box or boxes or writes down basic information to indicate which family member suffered from an ailment or a medical condition. When doctors are made of aware of the medical history of her family, it gives them one more way to check for illnesses. For example, if a patient's family has a history of high blood pressure, the doctor should check the patient's blood pressure routinely to ensure that she does not suffer from high blood pressure, as well.


In most cases, a family medical history form will require the patient to indicate whether immediate family members, such as grandparents, parents, and siblings, are alive or deceased. If they are deceased, the form will usually inquire as to how they died and at what age. Again, the information is useful to doctors who are trying to predict genetic medical problems of the patient. Potential medical issues can often be prevented with appropriate medical and preventative care.

In addition, many medical conditions are recurring. This means that even though they were once cured, they may occur again and again. For example, if a patient once suffered from hypertension, it should be marked on the family medical history form. The hypertension may be under control and may never be a problem again or it could return every few years, putting the patient at risk for more serious issues.

Sometimes a patient may be unaware of specifics for her family history. For example, she may know that a grandparent died when she was young, but she may be unaware of the cause of death. With the appropriate amount of preparation, the cause of death can be discovered from other relatives and even from historical medical records. Finding the specifics for a family medical history form may take some time, but it may also be life-saving for the patient and the patient's descendants, as well.


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