You can use this space to track your family history of illness or disease. Be sure to discuss your family history with your doctor.
| Condition or Diagnosis | Lung Cancer |
| Reported Date | 4/2/87 |
| Family Member Relationship | Mother |
| Status | Deceased |
| Source | Self-reported |
| Condition or Diagnosis | Heart Attack |
| Reported Date | 9/14/92 |
| Family Member Relationship | Father |
| Status | Deceased |
| Source | Self-reported |
| Condition or Diagnosis | Heart Disease |
| Reported Date | 7/18/05 |
| Family Member Relationship | Brother |
| Status | Living |
| Source | Self-reported |
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