Medical History
Habits
Alcoholic Beverages
Marijuana
Illnesses/Exposure to Infectious Disease
Heart and Lungs
Intestinal
Women's Health
Neurologic
Urologic
Blood Transfusions
Surgery
Family History
Please give current health history of each relative. Include any Chronic Diseases such as Diabetes, High Blood Pressure, Kidney Disease, etc. (If deceased, please list cause of death and age at death.)