Get the free IOWA Cystic Fibrosis Carrier Screen Test Request Form - shl uiowa
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PATIENT: Specimen Type: Check appropriate specimen and fill in requested information (Only one sample per form×. Last BIRTH DATE: mm 4 ml blood in EDTA tube’s) / dd / first SSN #: year ADDRESS:
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How to fill out iowa cystic fibrosis carrier
How to fill out Iowa Cystic Fibrosis Carrier form:
01
Obtain the necessary form: The Iowa Cystic Fibrosis Carrier form can be obtained from the Iowa Department of Public Health's website or from a healthcare provider.
02
Read the instructions: Before filling out the form, carefully read the provided instructions. This will ensure that you understand the purpose of the form and how to accurately complete it.
03
Provide personal information: The form will require you to provide personal information such as your full name, date of birth, and contact details. Make sure to accurately fill in this information.
04
Answer medical history questions: The Iowa Cystic Fibrosis Carrier form may include questions regarding your medical history or the medical history of your family. Answer these questions truthfully and to the best of your knowledge.
05
Sign and date the form: Once you have completed filling out the form, sign and date it at the indicated spaces. Your signature signifies that the information provided is accurate and complete to the best of your knowledge.
Who needs Iowa Cystic Fibrosis Carrier form:
01
Couples planning to have children: The Iowa Cystic Fibrosis Carrier form is typically required for couples who are planning to have children. This form helps determine the risk of passing on the cystic fibrosis gene to their offspring.
02
Individuals with a family history of cystic fibrosis: If you have a family history of cystic fibrosis, healthcare providers may recommend filling out the Iowa Cystic Fibrosis Carrier form to assess your carrier status and provide guidance for family planning.
03
Individuals seeking genetic counseling: Those who are seeking genetic counseling or have been referred by their healthcare provider may also need to fill out the Iowa Cystic Fibrosis Carrier form. This form assists genetic counselors in assessing the risk factors and providing appropriate guidance.
Note: It is important to consult with a healthcare provider or genetic counselor for accurate information and personalized advice regarding the need for the Iowa Cystic Fibrosis Carrier form.
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