The Health History Questionnaire
The Risk Assessment Program at Fox Chase Cancer Center is a clinical and research service within the Department of Clinical Genetics that offers education, screening and counseling to individuals with cancer and those who are at risk of getting cancer.
Before your first visit it’s important that you complete a Health History Questionaire (HHQ).
Health History Questionnaire (HHQ)
The Health History Questionnaire is the main tool for cancer risk assessment. The HHQ collects your family history and medical information. This is an online form. Once you have been scheduled for the program, you will be provided the website link, plus a username and password so that your information remains secure. It's very important to complete the HHQ before your visit so the Risk Assessment Team has all the facts they need to assess your risk.
The HHQ is divided into sections to find out if you have specific risk factors for cancer.
Section 1: Family History
This is a very important part of the HHQ. In this section, you need to gather information about your family members who have had cancer including:
- The type of cancer
- The age the cancer started
- If your relatives are still living or have died
The information is needed for your closest relatives: your parents, brothers and sisters, children, aunts and uncles and grandparents. Knowing your family history of cancer helps to find out whether the cancer in your family looks like an inherited pattern. That is why we ask you to try to collect as much information as possible about your family history before you come for your visit.
Section 2: Your Health History
This section has questions about your own health. There are questions about your past and current medical conditions and things in your environment such as tobacco, alcohol and other exposures that influence cancer risk.
There is also a section on diet and exercise.
Have your medical information handy to complete the HHQ.
It may help to have your medical records handy when you begin. This will help with dates of your recent screening tests, as well as any reports from biopsies you may have had.
Get information from your family before you begin.
Call family members who may be able to help with missing information and explain why you are asking these types of questions. Offer to call back if the person needs more time. Ask if someone else in the family may know some of the information. You may not be able to get complete information. Understand that sometimes family members might prefer not to talk about the family history. That is okay and we will work with any information that you provide.
It's okay to estimate.
You might not be able to remember when you had your last colonoscopy or the year your grandmother was born. Give your best estimate if you don't know exact dates. For example, if you think someone was about 75 when he was diagnosed with cancer, write in and circle "75". If you don't have an estimate, just write in a question mark (?). If you are completing the HHQ online, you will check the "estimate" box if you are not sure of a date or age.
You have taken the first step toward understanding your risk factors for cancer.
Please call the Fox Chase Cancer Center Risk Assessment Program at 877-627-9684 to schedule an appointment with our Risk Assessment Team.
Or complete the online form and one of our staff will contact you.