
- Note the relative’s name, date of birth or age, and sex.
- Do you have any chronic diseases or health conditions? (heart disease, diabetes)
- Do you have high blood pressure or high cholesterol?
- Have you ever had a heart attack or stroke? If so, age of incident.
- Do you have any type of cancer?
- Have you experienced any dental problems? (cavities, gum disease, oral cancer, tooth loss)
- Do you have a history of alcoholism, tobacco, or poor diet and exercise?
- Did you or your partner have any pregnancy complications? (miscarriages, premature births, birth defects)
- When was the last time you visited the doctor?
- When was the last time you visited the dentist?
- Do you have any mental illnesses or disabilities?
- Do you have any physical disabilities? (hearing loss, vision loss)
- Have you struggled with obesity?
- What medications are you currently taking and what are they for?
- At what age were you diagnosed with your medical problems?
- What treatments helped control your condition?
- Did your parents, grandparents, or any other relatives have any of the same or different health problems?
- For deceased relatives, record their age and cause of death.
Once you’ve collected your family health information, organize it so you can share it with Dr. Locke, as well as your family physician. Once you know your threats of family disease and problems, Dr. Locke can take appropriate action to diagnose and treat complications to keep you healthy. Schedule an appointment with our dental office in Waco, Texas at (254) 776-4888 to assess your risks.