Personal and Family Health History Survey

Personal and Family Health History Survey

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
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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, sisters, and/or children?

Have you or anyone in your family ever been diagnosed with the following cancer conditions? Think only of the people you are related to by blood. Select all that apply.

Have you or anyone in your family ever been diagnosed with the following heart and blood conditions? Think only of the people you are related to by blood. Select all that apply.

Have you or anyone in your family ever been diagnosed with the following digestive conditions? Think only of the people you are related to by blood. Select all that apply.

Have you or anyone in your family ever been diagnosed with the following hormone and endocrine conditions? Think only of the people you are related to by blood. Select all that apply.

Have you or anyone in your family ever been diagnosed with the following kidney conditions? Think only of the people you are related to by blood. Select all that apply.

Have you or anyone in your family ever been diagnosed with the following lung conditions? Think only of the people you are related to by blood. Select all that apply.

Have you or anyone in your family ever been diagnosed with the following brain and nervous system conditions? Think only of the people you are related to by blood. Select all that apply.

Have you or anyone in your family ever been diagnosed with the following mental health or substance use conditions? Think only of the people you are related to by blood. Select all that apply.

Have you or anyone in your family ever been diagnosed with the following bone, joint, and muscle conditions? Think only of the people you are related to by blood. Select all that apply.

Have you or anyone in your family ever been diagnosed with the following hearing or eye conditions? Think only of the people you are related to by blood. Select all that apply.

Have you or anyone in your family ever been diagnosed with the following other conditions? Think only of the people you are related to by blood. Select all that apply.

Have you ever been diagnosed with the following conditions? Select all that apply.

options and variations for each of the questions above noted below:

  • Including yourself, who in your family has had…? Select all that apply
  • Are you still seeing a doctor or health care provider for this condition?
  • About how old were you when you were first told you had this condition?
  • Are you currently prescribed medications and/or receiving treatment for this condition?