| Personal history of bleeding and description of bleeding events |
| Frequency |
| Severity (including need for any medical or surgical treatments) |
| Anatomic location |
| Spontaneous or provoked |
| Complete medication history, including OTC medications (many of which contain aspirin or NSAIDs) |
| History of excessive or prolonged bleeding after trauma or surgery (including dental procedures) |
| History of menorrhagia* (including age of onset) or excessive postpartum bleeding in women |
| Family history of any of the above bleeding sequelae or of a known heritable bleeding disorder (or consanguinity in cases of autosomal recessive disorders8) |
| Personal or family history of blood product transfusion and the reasons for transfusion, if known |
| Personal history or symptoms of any conditions associated with coagulopathy (eg, liver disease) or with specific bleeding disorders (eg, malignancy or autoimmune disease in acquired hemophilia) |
| History of recurrent miscarriage in women† |
| Personal or family history of thrombotic events‡ |
↵* Menorrhagia is defined by heavy menstrual bleeding of more than 7 days' duration7; >80 mL of blood loss per menstrual cycle7; needing to change sanitary pads or tampons more than hourly11; or passage of clots >1.1 inch in diameter.11
↵† Recurrent miscarriage may be a feature of some congenital factor (eg, factor XIII) and fibrinogen deficiencies.10
↵‡ Arterial or venous thromboses may be a feature of some congenital factor (eg, factor XI, factor VII, fibrinogen, factor V, and factor XIII) deficiencies.9
NSAID, nonsteroidal anti-inflammatory drug; OTC, over the counter.