Family Genetic History Form – Cheap Research Essays

Purpose: This assignment is to help you gain insight regarding the influence of genetics on an individual’s health and risk for disease. You are to

obtain a family genetic history on a willing, nonrelated, adult participant.
Disclaimer: When taking a family genetic history on an actual client, it is essential that the information is accurate. Please inform the person

you are interviewing that they do NOT need to disclose information that they wish to keep confidential. If the adult participant decides not to

share information, please write, “Does not want to disclose.”
Directions: Refer to the Family Genetic History guidelines and grading rubric found in Doc Sharing to complete the information below. This

assignment is worth 100 points.
Type your answers on this form. Click “Save as” and save the file with the assignment name and your last name, e.g.,

“NR305_Family_Genetic_History_Form_Smith”. When you are finished, submit the form to the Family Genetic History Dropbox by the deadline indicated

in your guidelines. Post questions in the Q & A Forum or contact your instructor if you have questions about this assignment.
1: Family Genetic History (35 points):
Develop a family genetic history that includes, at a minimum, three generations of your chosen adult’s family, including grandparents, parents, and

the adult’s generation. If the adult has any children, include them as the fourth generation. **PLEASE NOTE: This assignment is to reveal the

potential impact of the family’s health on the adult participant. You do not need to identify anyone who is not biologically related to the adult

except for a spouse or significant other.
You do not need to use symbols, but instead write brief descriptions for each person. Each description should include the following information:

first name, birthdate, death date, occupation, education, primary language, and a health summary, including any medical diagnoses. An example is

below:
Family Member Description
Paternal grandfather
First and last initials: RL
Birthdate: 1921
Death date: 1981
Occupation: Retired as a coal miner
Education: 6th grade
Primary language: English
Health summary: He was diagnosed with chronic lung disease, diabetes, and hypertension. He died from a heart attack.
Paternal grandmother
First and last initials: ML
Birthdate: 1932
Death date: 1998
Occupation: House wife
Education: Does not want to disclose
Primary language: English
Health summary: Diagnosed with chronic lung disease from smoking cigarettes. Died from heart failure.
This example points to common problems among this generation on both sides of the family. Consider the implications this would have for the adult

participant’s health if these were that person’s family members.
Complete the family genetic history form below. Indicate if any information is N/A (not applicable) or unknown. Indicate any information the person

did not want to disclose by noting “Does not want to disclose.”
Family Member Description
Paternal grandfather
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
Paternal grandmother
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
Father
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
Father’s siblings (write a brief summary of any significant health issues)
Maternal grandfather
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
Maternal grandmother
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
Mother
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
Mother’s siblings (write a brief summary of any significant health issues)
Adult Participant
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
Adult participant’s siblings (write a brief summary of any significant health issues)
Adult participant’s spouse/significant other
First and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
Adult participant’s children (write a summary for each child, up to four children)
Child #1 first and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
Child #2 first and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
Child #3 first and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary:
Child #4 first and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary language:
Health summary: