Get the free HEREDITARY CANCER GENETICS REFERRAL FORM - thocc

HEREDITARY CANCER GENETICS REFERRAL FORM Please complete this form and return via FAX to one of the following locations: Helen & Harry Gray Cancer Center 80 Seymour Street Hartford, CT 06102 Attn:

How to fill out hereditary cancer genetics referral

How to fill out hereditary cancer genetics referral:

1. Obtain the necessary referral form from a healthcare provider or genetic counselor specializing in cancer genetics.
2. Fill out the patient's personal information accurately, including their name, date of birth, contact information, and any relevant medical history.
3. Provide information about the patient's family history of cancer, including any known cases of hereditary cancers, such as breast, ovarian, colon, or prostate cancer.
4. Include details about any other family members who have been diagnosed with cancer and specify their relationship to the patient.
5. Indicate the patient's reason for seeking a hereditary cancer genetics evaluation, such as a personal diagnosis of cancer, a strong family history of cancer, or a known genetic mutation within the family.
6. Include any additional relevant medical information, such as previous genetic testing results or specific concerns regarding hereditary cancer risk.
7. If available, attach any supporting documentation or medical records that may aid in the evaluation process.
8. Review the completed referral form for accuracy and completeness before submitting it to the designated healthcare provider or genetic counselor.

Who needs hereditary cancer genetics referral:

1. Individuals with a family history of hereditary cancers, especially those with multiple affected family members or cases of cancer at younger ages.
2. Individuals who have been diagnosed with cancer at a young age (before age 50) or with rare types of cancer.
3. Individuals with certain ethnic backgrounds known to have an increased risk of specific hereditary cancer syndromes, such as Ashkenazi Jewish ancestry and increased risk of carrying BRCA mutations.
4. Individuals who have previously tested positive for a cancer-related genetic mutation and are seeking additional information or guidance on managing their cancer risk.
5. Individuals who have concerns or questions regarding their personal or family history of cancer and are seeking clarification or peace of mind through a hereditary cancer genetics evaluation.
6. Healthcare providers or genetic counselors may also suggest a hereditary cancer genetics referral based on their assessment of a patient's medical or family history.

For pdfFiller’s FAQs

What is hereditary cancer genetics referral?

Hereditary cancer genetics referral is a process of referring individuals with a strong family history of cancer to a genetic counselor or specialist for further evaluation and testing.

Who is required to file hereditary cancer genetics referral?

Healthcare providers such as doctors, oncologists, or genetic counselors are typically required to file hereditary cancer genetics referral for their patients.

How to fill out hereditary cancer genetics referral?

Hereditary cancer genetics referral can be filled out by providing detailed information about the patient's family history of cancer, any genetic testing that has been done, and the reason for the referral.

What is the purpose of hereditary cancer genetics referral?

The purpose of hereditary cancer genetics referral is to identify individuals who may be at increased risk for hereditary cancer syndromes and to provide personalized risk assessment and management recommendations.

What information must be reported on hereditary cancer genetics referral?

Information such as the patient's personal and family medical history, any genetic testing results, and the reason for the referral should be reported on hereditary cancer genetics referral.

How do I edit hereditary cancer genetics referral online?

The editing procedure is simple with pdfFiller. Open your hereditary cancer genetics referral in the editor. You may also add photos, draw arrows and lines, insert sticky notes and text boxes, and more.

Can I create an eSignature for the hereditary cancer genetics referral in Gmail?

With pdfFiller's add-on, you may upload, type, or draw a signature in Gmail. You can eSign your hereditary cancer genetics referral and other papers directly in your mailbox with pdfFiller. To preserve signed papers and your personal signatures, create an account.

How do I edit hereditary cancer genetics referral on an Android device?

With the pdfFiller mobile app for Android, you may make modifications to PDF files such as hereditary cancer genetics referral. Documents may be edited, signed, and sent directly from your mobile device. Install the app and you'll be able to manage your documents from anywhere.