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Required Forms
For any specific gene sequence analysis, known familial mutation test, or CopyDx quantitative analysis of a single gene...
1.
Use the 5-page requisition form called:
Genetic Test Sample Submission Form
2.
Please use an Informed Consent Document to discuss the benefits, limitations, and risks associated with genetic testing. Consents should be signed by the individual being tested (or guardian), the individual who explained the testing, and by a witness. Suggested texts are provided:
DIAGNOSTIC SEQUENCING TESTS: Consent documents containing the sensitivity information for specific genes and diagnoses can be found by locating the Gene or Disease to be tested under Diagnostic Tests in the menu on the left.
OTHER TESTS OFFERED: All-purpose consent documents (for any gene) for CopyDx, Carrier tests, or Mutation Confirmation services can be found by clicking those sections of the menu on the left.
OR
For GenomeDx Oligo Array CGH...
1.
Use the 2-page requisition form called:
GenomeDx Sample Submission Form
2.
Note that GenomeDx Oligo Array CGH testing has a mandatory statement of informed consent. It is attached as a third page to the above form.
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