Get Intelligene Cg Family/personal History Assessment Form

Filling out the Intelligene CG Family/Personal History Assessment Form is an important step in providing your healthcare provider the necessary information for hereditary cancer genetic testing. This guide will help you navigate the form step-by-step, ensuring you provide accurate and comprehensive information.

Follow the steps to complete the assessment form effectively.

1. Click the ‘Get Form’ button to access the Intelligene CG Family/Personal History Assessment Form and open it in your preferred editing software.
2. Begin by entering your full name in the designated field at the top of the form. This identifies you as the patient completing the assessment.
3. Move to the section regarding your personal and family history of cancer. For each type of cancer listed, check any that apply to yourself and your 1st degree relatives. For other relatives, use the appropriate fields to provide the relation and the age at diagnosis, even if it is an estimate.
4. Fill out the second section for your 2nd and 3rd degree relatives. Specify the relationship (mother’s side or father’s side) and the type of cancer diagnosed, along with their age at the time of diagnosis.
5. If applicable, indicate if your family is of Ashkenazi Jewish descent by checking the corresponding box. This information can be relevant for assessing hereditary cancer risk.
6. If you or someone in your family has undergone testing for a hereditary cancer syndrome, describe the testing and summarize the results in the provided space.
7. After carefully completing all sections, review the information you've provided for accuracy and completeness.
8. Finally, save your changes, and choose to download, print, or share the completed form as needed to submit it to your healthcare provider.

Take the next step towards understanding your health by completing your Intelligene CG Family/Personal History Assessment Form online today.