Dr Niri Eitana Carroll, M S for UC Davis Health 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name and appointment date at the top of the form. This ensures that your information is correctly associated with your visit.
3. Fill in your ancestry or ethnicity. This section helps the clinic understand any genetic predispositions.
4. Complete the family history sections. For each family member, provide their current age or age at death, cancer type (if applicable), and age at diagnosis. Be thorough and include all relatives on both sides of your family.
5. If you have relatives who have undergone genetic testing, note this and prepare to submit their laboratory reports as well.
6. Review all entries for accuracy before finalizing. Use our platform's tools to make any necessary edits easily.
7. Once completed, save your document and return it via fax or mail as instructed, ensuring it reaches the office before your appointment.

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