MEDICAL FAMILY TREE

Knowing your family What causes of death are important medical history to note? could save your life. The cause of death is especially notable if Studies show that the cause of death was one of the medical uncovering diseases conditions listed in the previous question. and health problems Also, if the person died at a relatively young that lurk in your family age, that should also be noted. tree can help predict illnesses that you and your family are likely to How does my relatives’ health affect me? face. By knowing your family medical history, Your biological parents, siblings and children you and your physician can determine share half of your genes and, therefore, any your risk for developing hereditary medical hereditary conditions that they may have conditions. You may be able to prevent or will have a greater chance of affecting you. delay the onset of these medical conditions, Grandparents, aunts and uncles, and nieces or your physician may be able to detect and nephews share 25% of your genes. problems earlier through special screenings Great-grandparents and cousins share even and tests. less of your genetic makeup. However, any pattern is significant as it increases your risk Which diseases should I look for in my of developing that condition. family’s medical history? Look for the following diseases that tend to If there is not enough space provided for the run in families: Alzheimer’s, cancer, diabetes, health history of every member of your family on heart diseases, joint diseases, obesity, the following pages, please use additional sheets osteoporosis, Parkinson’s disease, thyroid of paper. problems, allergies, asthma and glaucoma.

Community Outreach Department 1003 Willow Creek Road, Prescott, Arizona 86301 (928) 771-5686 MY FAMILY HEALTH TREE This Tree belongs to: Paternal Side

Father:

Still Living? Y N If no, cause:

HBP/Cholesterol? Y N Diabetes? Y N

Breast Cancer? Y N Heart Disease? Y N

MY STATS Substance Abuse? Y N Colon Cancer? Y N Age Stroke? Y N Depression? Y N Height Weight B.M.I

Paternal Grandmother: Paternal Grandfather:

Still Living? Y N If no, cause: Still Living? Y N If no, cause:

HBP/Cholesterol? Y N Diabetes? Y N HBP/Cholesterol? Y N Diabetes? Y N

Breast/Ovarian Cancer? Y N Heart Disease? Y N Breast Cancer? Y N Heart Disease? Y N

Substance Abuse? Y N Colon Cancer? Y N Substance Abuse? Y N Colon Cancer? Y N

Stroke? Y N Depression? Y N Stroke? Y N Depression? Y N

Sibling: Sibling:

Still Living? Y N If no, cause: Still Living? Y N If no, cause:

HBP/Cholesterol? Y N Diabetes? Y N HBP/Cholesterol? Y N Diabetes? Y N

Breast/Ovarian Cancer? Y N Heart Disease? Y N Breast Cancer? Y N Heart Disease? Y N

Substance Abuse? Y N Colon Cancer? Y N Substance Abuse? Y N Colon Cancer? Y N

Stroke? Y N Depression? Y N Stroke? Y N Depression? Y N

Other:

Still Living? Y N If no, cause:

HBP/Cholesterol? Y N Diabetes? Y N

Breast/Ovarian Cancer? Y N Heart Disease? Y N

Substance Abuse? Y N Colon Cancer? Y N

Stroke? Y N Depression? Y N MY FAMILY HEALTH TREE Maternal Side

Mother:

Still Living? Y N If no, cause:

HBP/Cholesterol? Y N Diabetes? Y N

Breast Cancer? Y N Heart Disease? Y N

Substance Abuse? Y N Colon Cancer? Y N

Stroke? Y N Depression? Y N

Maternal Grandmother: Maternal Grandfather:

Still Living? Y N If no, cause: Still Living? Y N If no, cause:

HBP/Cholesterol? Y N Diabetes? Y N HBP/Cholesterol? Y N Diabetes? Y N

Breast/Ovarian Cancer? Y N Heart Disease? Y N Breast Cancer? Y N Heart Disease? Y N

Substance Abuse? Y N Colon Cancer? Y N Substance Abuse? Y N Colon Cancer? Y N

Stroke? Y N Depression? Y N Stroke? Y N Depression? Y N

Sibling: Sibling:

Still Living? Y N If no, cause: Still Living? Y N If no, cause:

HBP/Cholesterol? Y N Diabetes? Y N HBP/Cholesterol? Y N Diabetes? Y N

Breast/Ovarian Cancer? Y N Heart Disease? Y N Breast Cancer? Y N Heart Disease? Y N

Substance Abuse? Y N Colon Cancer? Y N Substance Abuse? Y N Colon Cancer? Y N

Stroke? Y N Depression? Y N Stroke? Y N Depression? Y N

Other:

Still Living? Y N If no, cause:

HBP/Cholesterol? Y N Diabetes? Y N

Breast/Ovarian Cancer? Y N Heart Disease? Y N

Substance Abuse? Y N Colon Cancer? Y N

Stroke? Y N Depression? Y N Notes

“In every conceivable manner, the family is link to our past, bridge to our future.” — ALEX HALEY

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