Family Medical History Survey

Participant Surveys: Family Medical History

For this survey, the following applies to all questions:

Original source question text
Not applicable

From which existing source was this question derived?
This question was developed specifically for use within the All of Us Research Program

Year of Original Source
Not applicable

Brief Description
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URL
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How much do you know about illnesses or health problems for your parents, grandparents, brothers,How much do you know about illnesses or health problems for your parents, grandparents, brothers, sisters, and/or children?

Please indicate if your mother has ever been diagnosed with the following health conditions and/or health events. Think only of the person you are related to by blood. (select all that apply)

Please indicate if your father has ever been diagnosed with the following health conditions and/or health events. Think only of the person you are related to by blood. (select all that apply)

Please indicate if your brothers and/or sisters [people with the same mother and/or father as you] have ever been diagnosed with the following health conditions and/or health events. Think only of those people you are related to by blood. If you have more than one brother or sister, check the box if any of your brothers or sisters have the condition (select all that apply)

Please indicate if your daughter(s) has/have ever been diagnosed with the following health conditions and/or health events. Think only of those people you are related to by blood. (select all that apply)

Please indicate if your son(s) has/have ever been diagnosed with the following health conditions and/or health events. Think only of the person you are related to by blood. (select all that apply)

Please indicate if your grandparent(s) have ever been diagnosed with the following health conditions and/or health events. Think only of those people you are related to by blood. (select all that apply)