Your Family Health and Medical Record

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Note: This Family Health and Medical Record booklet has been formatted as a fill-in PDF form. You will be able save the file with your information filled-in.

Can you answer “yes” to all of these questions?

  • Do you know the important health and medical events for each of your family members?
  • Do you have a complete listing of all the shots your children have received and when they received them?
  • Do you accurately remember your own childhood illnesses and injuries?
  • Do you know about special health problems of your parents?

If you answered “no” to one or more of the questions, this booklet will be of help to you.

To remember the details about your family’s health, a system of record keeping is helpful. This Family Health and Medical Record booklet provides a way for you to keep track of health information about your family.

If families used only one doctor and one dentist, they would each keep a health record for your family. Many families, however, use more than one doctor. Often the children have a pediatrician and the mother, a gynecologist. Perhaps there is a different doctor for the father. This same family might also use more than one dentist or a dentist and an orthodontist. In cases like this, one way to have a single health record for the entire family is to keep it yourself.

Families without a health record face a problem when they move. They have no health records for a new doctor, dentist, or for their children when they enter their new school.

In addition to the value of keeping a family health record for filling out applications for school, jobs, and insurance, such a record has other important advantages. Your health record or this Family Health and Medical Record may spare you the expense of copying records of past medical tests and procedures. It will help a new doctor develop health histories for your family members. It can also give information that may help you get faster and more accurate health and medical care.

If you have children, a health record can improve your effectiveness as a parent. A health record will provide you more information about your child so when a need arises you will be better able to get help. In an emergency, it can tell the doctor about what medications your child is allergic to, or how long ago your child had a tetanus shot. In later life, your child will have an accurate record of injuries, illnesses, and other events that they otherwise might have forgotten.

How you use the Family Health and Medical Record will determine its real value. When a family member visits a doctor or dentist, make sure they take this booklet with them. This will help keep the record accurate and up-to-date.

Keep this booklet in a safe and handy place. It will be a useful and valuable record for many years.

Download PDF BookletOpens new window
Note: This Family Health and Medical Record booklet has been formatted as a fill-in PDF form. You will be able save the file with your information filled-in.


Prepared by: Janet M. Pollard, M.P.H., Extension Associate–Health; Carol Rice, Ph.D., R.N., Professor and Extension Health Specialist; Kathleen Greer, B.S., former HERO Project Program Coordinator, Texas A&M AgriLife Extension Service, Texas A&M System, 1998. (B-1377)

Adapted for Texas from materials developed by Lawrence B. O’Reilly, Extension Health Specialist, and Jane A. Scherer, Project Coordinator, CHEP, Cooperative Extension Service, University of Illinois at Urbana-Champaign, with financial assistance from the Illinois State Board of Education.


Last updated: March 25, 2015

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