Form: Family origin questionnaire: sickle cell and thalassaemia screening

Public Health England

October 1
14:53 2019

The Family Origin Questionnaire

This file may not be suitable for users of assistive technology. Request an accessible format.

If you use assistive technology (such as a screen reader) and need aversion of this document in a more accessible format, please email tell us what format you need. It will help us if you say what assistive technology you use.


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

APS Group

Order leaflets directly using the APS online ordering portal:

If you have any problems ordering from the site please call or email.

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

Published 1 February 2014
Last updated 1 October 2019 +show all updates
  1. Updated version of the family origin questionnaire.
  2. Updated 'Family origin questionnaire'.
  3. First published.

Recent Comments

Follow Us on Twitter

Share This

Enjoyed this? Why not share it with others if you've found it useful by using one of the tools below: