Get the free Genetic Counseling Referral Form - GeneDx

Genetic counseling services provided by Kate Lynch, MS (301) 519-2100 x6236 (P) (877) 824-1549 (F) Kate genedx.com (E) Request for Cardiology Genetic Counseling/Testing Services Provided by Gene at

How to fill out genetic counseling referral form

How to fill out a genetic counseling referral form:

1. Start by carefully reading the instructions provided on the form. Familiarize yourself with the required information and any specific sections that need to be completed.
2. Begin by providing your personal information on the form. This may include your full name, date of birth, contact details, and address. Make sure to write legibly and accurately.
3. Next, indicate your reason for seeking genetic counseling. This could include a family history of genetic disorders, concerns about passing on a genetic condition to future children, or a specific medical condition for which you are seeking guidance.
4. If applicable, provide details about any specific genetic tests you have undergone or wish to undergo. Include information about the testing laboratory, the date of testing, and any relevant results. This will help the genetic counselor have a better understanding of your situation.
5. If you have any known family history of genetic conditions or concerns, provide as much detail as possible. Include information about relatives who have been diagnosed with genetic disorders, any known genetic testing they have undergone, and their relationship to you (e.g., parent, sibling, grandparent).
6. Indicate any specific questions or concerns you have regarding genetics. This could include inquiries about the risks of passing on a genetic condition, the availability of genetic testing, or options for genetic counseling and support.
7. If your genetic counseling referral is being made by a healthcare professional, ensure that all their contact information is accurately provided on the form. This will allow the genetic counselor to easily communicate with them and obtain any additional medical information if needed.
8. Finally, review the completed form to ensure all sections are filled out accurately and completely. Double-check for any spelling errors or missing information. If necessary, seek assistance from a healthcare professional or the genetic counseling clinic to ensure the form is completed correctly.

Who needs a genetic counseling referral form:

1. Individuals who have a family history of genetic disorders or concerns about passing on genetic conditions to future children may need a genetic counseling referral form.
2. Those who have been diagnosed with a medical condition that has a genetic component and require guidance regarding the implications and potential risks may also require a referral for genetic counseling.
3. Healthcare professionals, such as primary care physicians, obstetricians, or geneticists, may refer their patients for genetic counseling if they believe it would be beneficial in understanding and managing a genetic risk or condition.
4. Couples who are planning to start a family and want to assess their genetic risks or determine the likelihood of passing on a genetic condition may also seek a genetic counseling referral.
5. Individuals who have undergone genetic testing and desire counseling to understand the results, implications, and potential options for addressing any identified genetic conditions or risks may benefit from genetic counseling and thus require a referral form.

Remember, the specific criteria for who needs a genetic counseling referral form may vary depending on the healthcare system or institution. It is always best to consult with a healthcare professional or genetic counseling clinic to determine if a referral is necessary in your particular situation.

For pdfFiller’s FAQs

What is genetic counseling referral form?

The genetic counseling referral form is a document used to refer patients to genetic counselors for evaluation and counseling.

Who is required to file genetic counseling referral form?

Healthcare professionals, such as physicians, nurse practitioners, and genetic counselors, are required to file the genetic counseling referral form.

How to fill out genetic counseling referral form?

To fill out the genetic counseling referral form, healthcare professionals need to provide patient information, medical history, and reason for referral.

What is the purpose of genetic counseling referral form?

The purpose of the genetic counseling referral form is to facilitate the referral process for patients who may benefit from genetic counseling services.

What information must be reported on genetic counseling referral form?

The genetic counseling referral form must include patient demographic information, family history of genetic conditions, and reason for referral.

Can I edit genetic counseling referral form on an iOS device?

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