Please list a detailed medical history for all members of your family that are genetically related to you. Please list all chronic diseases, infectious diseases, medical problems, and causes of death, including conditions like cancer, heart disease, TB, sexually transmitted diseases, diabetes, arthritis, autoimmune issues, suicide, murder, accidental deaths, early death, problems with surgery, congenital disorders, etc.
Please include the following people, always indicating which side of the family they come from if it is not obvious:
| Mother | Father |
| Paternal grandmother | Paternal Grandfather |
| Maternal grandmother | Maternal Grandfather |
| Great Grandparents | Great aunts/uncles |
| Aunts | Uncles |
| Cousins | Siblings |