Welcome to the Centura Health Genetic Counseling Program
Family History Questionnaire

Now that you have scheduled your genetic counseling appointment, we ask that you complete an online family history questionnaire. This questionnaire will be used by you and your genetic counselors to help you better understand the likelihood of a hereditary condition in your family, to help you make decisions regarding medical management, and to help determine whether or not genetic testing may be a useful option for you or your family.

This online family history questionnaire needs to be completed prior to your appointment. Please complete this questionnaire to the best of your ability.

Select the hospital from the list below that you scheduled your genetic counseling appointment at in order to begin your questionnaire. If you have any questions or concerns about this family history questionnaire, please contact your genetic counseling clinic.



Phone: 303-269-4348

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Parker Adventist
Questionnaire

Phone: 303-765-3923

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Porter Adventist
Questionnaire

Phone: 303-734-3969

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Littleton
Questionnaire


Phone: 719-776-5279

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Penrose
Questionnaire

Phone: 719-557-5701

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St Mary-Corwin
Questionnaire

Phone: 720-321-8383

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St. Anthony
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Summit
Questionnaire


Phone: 720-321-8383

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Avista
Questionnaire
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Church Ranch
Questionnaire

Phone: 720-321-8383

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Longmont
Questionnaire

Phone: 720-321-8383

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North
Questionnaire