Family history of cancer questionnaire

Use this service to tell us about any family history of cancer.

You can use this service if you:

• are registered at the surgery

Before you start

We’ll ask you for:

• your first and last name, date of birth, sex, postcode, email and phone number
• if applicable, the details of the person you are completing the form on behalf of
• whether you have a family history of cancer
• the type(s) of cancer that have affected your family members

Start now

You can also phone us on 01384 987740.