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Genograms for nursing and medical family history

A medical family history is a genogram with the conditions in the foreground. Three generations are drawn in the standard notation, each condition is coloured and named in the key, and ages at diagnosis and at death are written beside the people they belong to. This page describes what the chart records in a clinic, how a pattern is read from it, which medical templates to open first, and where the printable sheet fits.

Last checked on 20 October 20267 minute read

Three generations with ages at diagnosis make the record

The family history taken in a clinic covers the patient, their parents, siblings and children, and their grandparents, aunts and uncles, which is three generations and both sides. For each relative the chart records a birth year, a year and cause of death where it applies, and each condition with the age at which it was diagnosed. The age matters more than the condition alone, because coronary disease at 43 and at 83 mean different things for the patient in front of you.

The early-onset heart disease template is a worked example. A teacher of 41 is referred to the lipid clinic with a raised LDL and corneal arcus. His father had a first myocardial infarction at 41 and died of a second at 48, his grandfather died at work of one at 43, an uncle had two stents at 52, and an aunt has had hypercholesterolaemia since 45. The pattern down the paternal line is visible without a word of text.

Maureen and Siobhan431936–1979Patrick DoyleSmokingDock worker861940–Maureen DoyleHypertensionRetired shopassistant641962–Teresa DoyleSchool secretary481960–2008Brian DoyleMyocardial infarctionSmokingBus driver631963–Kevin DoyleCoronary artery diseaseSmokingElectrician601966–Siobhan DoyleHypercholesterolaemiaPharmacist411985–Conor DoyleFamilial hypercholesterolaemiaSecondaryschool teacher381988–Aoife DoyleSmokingStaff nurse
Early-onset heart disease, paternal lineThe early-onset heart disease template. Ages at infarction and at death on the paternal line, with smoking marked as an addiction, active and in remission.

The key names every condition and whether it is present

Conditions are the foreground of a medical genogram, so the chart colours each person by condition and names every colour in the key, which is printed on every chart and every export. A condition can be present, suspected or in remission, and the mark differs for each, so a sister in whom polycystic ovary syndrome is suspected is distinguished from a mother whose gestational diabetes resolved after delivery.

The type 2 diabetes template is the simplest of the medical set and shows all three states in one family. The father has had type 2 diabetes since 46 and hypertension since 49, the son has an HbA1c in the prediabetes range at 25, the daughter has suspected polycystic ovary syndrome with an ultrasound pending, and the mother’s gestational diabetes is in remission. The household group shows who lives together and leaves out the adult son.

Patel household551971–Arjun PatelType 2 diabetesHypertensionIT projectmanager521974–Meera PatelGestational diabetesAccountant262000–Rohan PatelPrediabetesSoftwaredeveloper232003–Anika PatelPolycystic ovary syndromeUniversitystudent172009–Dev PatelSchool student
Type 2 diabetes in a nuclear familyThe type 2 diabetes template. Present, suspected and in remission in one nuclear family, with age at diagnosis on every condition.

An inherited pattern is read across the chart before any test

Where a condition runs in a family, the chart is read for the pattern of inheritance before a referral is made. The hereditary breast and ovarian cancer template draws a BRCA2 family on the father’s side across four generations, with male breast cancer and pancreatic cancer in a grandfather, ovarian cancer in an aunt who was never tested, an early breast cancer in a sister, and a brother who tested negative. The index patient is an unaffected carrier found on cascade testing.

The chart records who has been tested and with what result, who is untested and who is not a blood relative, since an adopted cousin with no cancer history says nothing about the variant. The Huntington’s disease template shows an autosomal dominant pattern with anticipation, and Queen Victoria’s family in the famous set shows X-linked inheritance through carrier daughters to affected sons.

Weiss–Tanaka householdadopted 1994adopted 1994751929–2004Samuel WeissBreast cancerPancreatic cancerTailor921934–Esther WeissRetiredbookkeeper891937–António SantosRetired fisherman861940–Fernanda SantosBreast cancerRetired cook711955–Alan KleinRetiredarchitect541957–2011Miriam KleinOvarian cancerMusic teacher661960–Jonathan WeissOptometrist641962–David WeissBRCA2 carrierProstate cancerCharteredsurveyor621964–Maria WeissRetired nurse321994–Noah KleinData analyst401986–Hannah WeissBreast cancerBRCA2 carrierSolicitor371989–Rachel WeissBRCA2 carrierSpeech therapist391987–Kenji TanakaChef112015–Lily TanakaSchool student
Hereditary breast and ovarian cancer across four generationsThe hereditary breast and ovarian cancer template. Carriers, a relative who tested negative, an untested aunt and an adopted cousin who is not a blood relative.

A draft from the clinic letter places each relative with its sentence

A family history is often taken as prose, in a referral letter or a clinic note, before anyone draws it, and the draft feature works from that prose. Paste the family history paragraph into the notes panel and the draft returns every person, union, parent line and condition it found, each marked as stated or inferred and each shown with the sentence it came from. A relative whose age at diagnosis is not given is listed without one rather than given a guess.

The draft does not calculate risk, does not apply a scoring system and does not infer a diagnosis from a symptom. It places what the letter says on the chart so that what the letter does not say becomes visible, which in a family history is usually the point. Five drafts a month come with a free account.

Your notes

Ellie Hawkins, born 2009, is the index patient and has generalised anxiety disorder. Her father, Paul Hawkins, born 1971, misused alcohol for many years and has been in recovery since 2019. Paul’s father, Walter Hawkins, born 1944, had heart disease and died in 2021. Paul’s mother, Joan Hawkins, born 1947, has had depression since his death.

Found in the notes

  • Ellie Hawkins, 2009, index
  • Paul Hawkins, 1971
  • Walter Hawkins, 1944, died 2021
  • Joan Hawkins, 1947
  • Ellie, generalised anxiety disorder
  • Paul, alcohol misuse, in recovery since 2019
  • Walter, heart disease
  • Joan, depression since 2021

On the chart

771944–2021Walter HawkinsHeart diseaseRetired postman791947–Joan HawkinsDepressionRetired schoolsecretary801946–Raymond FletcherRetired electrician771949–Pauline FletcherRetired pharmacyassistant571969–Carol HawkinsDistrict nurse531973–Neil HawkinsCar mechanic541972–Dawn ReillyUnknown551971–Paul HawkinsAlcohol misuseTrain driver521974–Helen HawkinsPrimary schoolteacher202006–Jack HawkinsApprenticeplumber172009–Ellie HawkinsGeneralised anxiety disorderSixth form student
A family history paragraph drafted into the chart. Each condition is placed on its person and named in the key, with the sentence that supports it.

The medical family history sheet is filled in before the appointment

The Templates page has a medical family history sheet as a free PDF and PNG, with three generations laid out and the condition marks in the key. It can be posted or handed to a patient before an appointment so that the history is gathered at home, where the patient can telephone a parent and check an age, rather than from memory in a ten-minute consultation.

From the sheet, type the history as sentences, let the draft place it, correct it against the sheet and the patient, and export a PDF for the record with the key on it. The JSON backup reopens the chart with its notes when the history is updated at a later visit.

  1. Send the sheet ahead

    Give the patient the medical family history sheet to fill in at home with their relatives.

  2. Type the history

    Write each relative with a birth year and each condition with the age at diagnosis.

  3. Review the draft

    Check each relative and condition against the sheet, and name anything that was set aside.

  4. Export for the record

    Save a PDF with the key for the notes and keep the JSON backup for the next visit.

From a sheet filled in at home to a chart in the patient record.

Before you decide

A family history is what the patient was told

Most of what goes on the chart is reported by the patient, who may not know a grandmother’s cause of death or may know it wrongly. Mark a condition as suspected when the report is uncertain, and write the source in the notes. The chart is a record of the history as given, not a verified pedigree.

Relatives who are not related by blood

An adopted child, a step-parent and a partner share a household but not a bloodline, and the notation draws each differently so that a pattern is not read through them. The parent lines distinguish biological, adopted, foster and step relationships, and the key names each.

Who sees the export

The chart holds diagnoses of people who are not the patient and have not consented to their being recorded. Keep the export within the patient record, and follow your service’s policy on third-party information before the chart is shared.

Where a genetics service wants its own pedigree

Genogram Builder draws the notation of McGoldrick, Gerson and Petry, which is the convention of family therapy and social work. A clinical genetics service may ask for a pedigree in its own convention, with different marks for carriers and probands. The chart drawn here is a sound starting record, but it is not drawn in that convention.

Open the medical templates and read a case, or paste a family history paragraph and review the draft. One chart of up to 50 people needs no account.

Open the editor