Family origin questionnaire: sickle cell and thalassaemia screening

This document allows healthcare professionals to assess whether an individual is a likely carrier for sickle cell and thalassaemia.



The Family Origin Questionnaire (FOQ) is a form to use in antenatal screening for sickle cell and thalassaemia (SCT).

Complete the form to help determine if a person is likely to be a carrier for SCT or other haemoglobin disorders.

In low prevalence areas of England, use the FOQ as a preliminary tool to assess the risk that the pregnant woman is a sickle cell carrier.

In high prevalence areas, fill in the form to assist the laboratory in the interpretation of results.

Communities at risk

The FOQ is relevant to SCT because the conditions are more common in people from some black and minority ethnic communities.

Genetic carriers for these conditions have some immunity from malaria in infancy. This trait makes the conditions more common in malarial regions of the world.

Midwives and health professionals can use the FOQ to ask individuals about whether they have family origins in malarial parts of the world.

Order hard copy of the FOQ

Harlow Printing Limited

Order leaflets directly using the form on the Harlow Printing website.

If you have any problems accessing this form please call or e-mail.

Please allow 10 working days for leaflets to arrive after placing an order.