Cholesterol
Colonoscopy/ Sigmoid
Mammogram
Pap Smear
Bone Density
Alcoholism/Drug Abuse
Asthma
Cancer
Depression/Anxiety/Bipolar/Suicidal
Diabetes
Emphysema (COPD)
Heart Disease
High Blood Pressure (hypertension)
High Cholesterol
Hypothyroidism/Thyroid Disease
Renal (kidney) Disease
Migraine Headaches
Stroke
Other
No Significant Family History is known.
Mother
Father
Brother
Sister
Child
MGM
MGF
PGM
PGF
Tobacco Use
Current
Past
Alcohol / Drug Use
Sexual Activity
Exercise
Duration
Sleep
Diet
Safety
Cardiology
Gastroenterologist (GI)
OB / GYN
Neurology
Pulmonary
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