(CANCER) 2026

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The document is a Family History Form for assessing cancer risk, intended for patients referred to a genetics department due to personal or family history of cancer. It requests detailed information about family members who have had cancer, including types of cancer, ages at diagnosis, and ethnic backgrounds. The form emphasizes confidentiality and instructs patients to provide as much information as possible, while also allowing space for additional relatives with relevant health conditions.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your personal details, including your home, daytime, and cellular telephone numbers. Indicate a good time for contact and whether it's okay to leave a message.
Fill in the ethnic background of both parents, as this information is crucial for assessing inherited cancer risks.
In the section regarding relatives with cancer, provide full names, dates of birth, and specify if they are alive or deceased. Include details about the type of cancer and age at diagnosis.
Complete any additional information about other relatives who may have relevant health conditions in the designated section.
Review all entered information for accuracy before submitting the form. Ensure that you return it by the specified deadline to facilitate your assessment.

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Versions	Form popularity	Fillable & printable
2016	4.8 Satisfied (238 Votes)

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(CANCER) 2026

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How to use or fill out the Family History Form (CANCER)

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