About This Resource

This is a part of our Headache Toolkit!

Since headaches tend to run in families, it’s helpful to know who else in the family gets headaches, what those headaches are like, and any treatments that have or haven’t helped. This makes it easier to figure out what’s going on with you, and gives some good clues about creating the best treatment plan. You fill this out this form to track anything you might know that could help you and your doctor figure out your treatment plan.

How To Use This Resource

PARENTS AND CAREGIVERS:  Fill this out to make it easier to provide your medical team with the family history information that is useful for creating a good treatment plan. 

KIDS AND TEENS: This is probably one that is going to be mostly filled out by the adults in your world, but definitely take a look for yourself.  Understanding your family history of headaches can help you figure out what is going to be best for you!

PROVIDERS: Ask the family to complete this ahead of their medical appointments so you can have relevant family history to formulate your treatment plan.