Get the free Genetics Referral Form - mission-health.org

Fullerton Genetics Center 9 Vanderbilt Park Drive, Asheville, NC 28803 Phone: 8282130022 Fax: 8282130039 Referral Form Date: P ...

How to fill out genetics referral form

How to fill out a genetics referral form:

1. Start by obtaining a genetics referral form from your healthcare provider. This form may be available online or you may need to request it from your doctor's office.
2. Read the form carefully and ensure that you understand all the information being requested. The form will typically ask for personal details such as your name, contact information, date of birth, and insurance information.
3. Provide a detailed medical history. This section may ask you to provide information about any genetic conditions or diseases that run in your family, as well as any relevant information about your own health history.
4. Include a reason for the referral. This section will typically ask you to explain why you are seeking genetic testing or consultation. Be as specific as possible and provide any relevant medical information that you believe is important for the geneticist to know.
5. If applicable, attach any relevant medical records or test results that may support your referral. These documents can provide further context and help the geneticist better understand your situation.
6. Review the completed form to ensure that you have provided all the necessary information accurately and legibly. Double-check for any errors or missing sections.
7. Submit the completed genetics referral form to the appropriate healthcare provider. You may need to mail it or drop it off at the designated location, depending on the instructions provided on the form.

Who needs genetics referral form:

1. Individuals who suspect they may have a genetic condition or who have a family history of genetic diseases may need a genetics referral form. This includes people who have experienced unexplained health issues, birth defects, or developmental delays.
2. Pregnant women or couples planning to start a family may also require a genetics referral form. This is especially true if there has been a history of genetic disorders within either partner's family.
3. Individuals who have already been diagnosed with a genetic condition may need a referral form to access genetic counseling or further testing to better understand their condition and make informed decisions about their healthcare.

In summary, anyone who wishes to explore their genetic risk or seek advice from a genetic specialist should consider filling out a genetics referral form. This form helps healthcare providers gather essential information about the patient's medical history and reason for referral, ensuring a comprehensive and personalized evaluation.

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