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Add Person     List All Select Person Chris Smith Pat Smith H E A L T H   R E C O R D Personal Information Doctors/Clinics Allergies Illnesses/Conditions > Medications/Supplements Family History Immunization History Record Summary T O O L S Immunization Planner To-do Reminder Health Risk Appraisal

Chris Smith Today's Date: mm/dd/yyyy  Add Medical Record to Family History The family history captures the health summaries of your natural relatives and can be shared with your physician in the course of care. Please enter all relevant medical history for this family member. Name: Relationship: Select Relationship Father Mother Brother Sister Paternal Grandmother Paternal Grandfather Maternal Grandmother Maternal Grandfather Date of Birth:   /  / mm/dd/yyyy   Unknown Alive   Deceased from at the age of Illnesses:  Alcoholism  Lung Cancer  Alzheimers  Heart Disease  Anemia  Depression  Asthma  Diabetes  Breast Cancer  High Blood Pressure  Cervical Cancer  Kidney Disorders  Colon Cancer  Thyroid Disease  Skin Cancer  Rheumatoid Arthritis  Ovarian Cancer  Stroke  Prostate Cancer  Ulcers Other: