Family History Chart

You may be at greater risk for some cancers if you have a personal or family history of cancer or certain diseases. To help determine your risk, complete this family medical history chart and share it with your health care professional and other family members.

For each blood relative, mark in the box if they have had cancer, the type of cancer they had and at what age they had it. This will help you and your health care professional decide which cancer screenings you may need and when to begin them.

Share this information with your health care professional to see when you should begin cancer screening.

**To view a downloadable version of the family history chart, click here.