Below, you will find some of the most common forms used by patients and providers.
If you’re a healthcare provider, you can easily find and download the forms most frequently used during the genetic testing process below.
The quickest way to place an order is via our online provider portal. Alternatively, you may place an order through client services at 301-519-2100, option 3 or submit a Test Requisition Form (TRF) via email to support@genedx.com or fax (201-421-2010).
Please note: GeneDx does not accept orders or specimens from the UK or European Union (EU) countries at this time.
GeneDx’s standard patient informed consent form can be found below, in multiple languages. Our patient informed consent form is also included with all of our test requisition forms, as the last two pages.
At GeneDx, we firmly believe that everyone deserves access to vital insights from genetic testing, regardless of their financial situation which is why we offer a robust Financial Assistance Program to help reduce the potential out-of-pocket costs associated with testing.
The program has broad eligibility criteria, meaning that most patients will qualify for some level of financial assistance.
Please send the form below to your patient and have them return the completed, signed application to billing@genedx.com.
In order to receive copies of patient medical records for patients who have received genetic testing that was ordered by another healthcare provider (e.g., genetic test results), please contact our Customer Service team at (888) 729-1206, option 3, or email support@genedx.com. To request raw data on patients (e.g., sequencing files), please contact the data send out team at clinicalgenomicsdata@genedx.com.
Here, you’ll find GeneDx’s genetic testing informed consent forms and policies about contact for research purposes, use of deidentified data, and specimen retention. If you have any questions, please contact our client services team at (888) 729-1206, option 3.
DNA specimens are not returned to individuals or to the referring healthcare providers. After testing is complete, the de-identified submitted specimen may be used for test development and improvement, internal validation, quality assurance, and training purposes. Specimens from residents of New York State will not be retained for more than 60 days after test completion and will not be included in the de-identified research studies (described below) unless specifically authorized by the patient.
De-identified health history and genetic information can help healthcare providers and researchers understand how genes affect health. Though patients undergoing testing may not personally or directly benefit, sharing this information may help healthcare providers offer better care for their patients. Sharing this information may also help researchers make discoveries that may help others. GeneDx shares this type of information with healthcare providers, researchers, and healthcare databases. No personal identifying information or protected health information will be shared, as it will be replaced with a unique code that is not derived from your personal identifiers.
Even though a code is used for reporting to the databases, there is a risk that a person could be re-identified based on the genetic and health information that is shared. GeneDx believes that this is unlikely, although the risk is greater if a person’s genetic or health information has been or will be shared with public or private resources such as genealogy websites.
Separate from the above, GeneDx may collaborate with researchers to advance knowledge of genetic diseases and to develop new treatments. If there are opportunities to participate in research relevant to a person’s test results or health condition, GeneDx may facilitate contact with the person’s healthcare provider. Examples may include the development of certain types of new testing, drug development, or new treatments. In some situations, such as if a person’s healthcare provider is not available, the person may be contacted directly.
Any research that results in medical advances, including new products, tests, or discoveries, may have potential commercial value and may be developed and owned by GeneDx or the collaborating researchers. If any individuals or corporations benefit financially from these studies, no compensation will be provided to study participants.
People who undergo testing at GeneDx may choose not to be recontacted for research participation and may do so at any time. Please use the Opt-out for being re-contacted for research participation form to let us know.
In order to receive copies of patient medical records for patients who have received genetic testing that was ordered by another healthcare provider (e.g., genetic test results), please contact our Customer Service team at (888) 729-1206, option 3, or email support@genedx.com. To request raw data on patients (e.g., sequencing files), please contact the data send out team at clinicalgenomicsdata@genedx.com.
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