Family Health History Template printable pdf download

Family Health History Template

MAPPING

YOUR FAMILY’S HEALTH HISTORY

MOTHER’S

SIDE

FATHER’S

SIDE

YOU

SIBLINGS

FURTHER

FAMILY

Family Health History

At Pink Hope we are dedicated to providing women with the tools to empower themselves and better understand their risk of

breast and ovarian cancer. One of the first steps on the journey to assessing your risk is mapping out your family health history.

Gathering details from both your father’s and mother’s side of the family greatly increases your chance of determining your

personal lifetime risk.

After finishing our family health history template, you can use the findings to assist in your completion of Pink Hope’s online risk

assessment tool, the Navigate Now Quiz .au/navigate-your-risk.

These resources will combine family history and lifestyle factors to provide you with a personalized breast and ovarian cancer risk

assessment, in printable PDF format, which you can then take to your next doctor’s appointment.

Mapping Tips!

For each individual in your family that you look into, make sure you write down the following details; their initials, date of birth/

death, any form of cancer they’ve had (in particular breast, gynaecological [ovarian], bowel, prostate or pancreatic cancer)

and the age at which the cancer commenced.

Remember that discussing family health matters can be difficult and requires sensitivity, respect and understanding. By being

proactive about researching family health history, seeking expert medical advice, learning about your options and taking action,

you can change your future!

With Pink Hope on your side, organising your family health history will be as easy as one, two, and three! Now, get mapping!

Pink Hope 02 8084 2288 | Info@.au

Family Health History Template