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MOLECULAR GENETICS TEST REQUEST FORM University of North Carolina Hospitals 101 Manning Drive Molecular Genetics Laboratory, Rm. 1046 Anderson Pay. Chapel Hill, NC 27514 Phone: (984) 9741825 Fax:

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How to fill out molecular genetics test request

01

Obtain the molecular genetics test request form from the testing laboratory or healthcare provider.

02

Provide your personal information such as name, date of birth, and contact details.

03

Fill out the medical history section, including any relevant past genetic testing results or family history of genetic disorders.

04

Specify the type of molecular genetics test you are requesting and provide reasons for the test.

05

If applicable, include information about the specific genes or genetic markers you want to be tested.

06

Ensure that all sections are completed accurately and legibly.

07

Sign and date the request form.

08

Submit the completed form to the testing laboratory or healthcare provider as instructed.

Who needs molecular genetics test request?

01

A molecular genetics test request is typically needed by individuals who require genetic testing to diagnose, predict, or understand genetic conditions or diseases.

02

This includes patients with suspected genetic disorders, individuals with a family history of genetic conditions, couples planning for pregnancy or considering genetic counseling, and individuals interested in genetic testing for personal reasons.

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What is molecular genetics test request?

A molecular genetics test request is a formal document submitted to a laboratory to perform genetic testing on specific DNA sequences.

Who is required to file molecular genetics test request?

Healthcare professionals, genetic counselors, or researchers are typically required to file a molecular genetics test request.

How to fill out molecular genetics test request?

To fill out a molecular genetics test request, the requester must provide detailed information about the patient, reason for testing, specific genes to be tested, and any relevant family history.

What is the purpose of molecular genetics test request?

The purpose of a molecular genetics test request is to identify genetic variations or mutations that may be linked to a particular disease or condition.

What information must be reported on molecular genetics test request?

Information such as patient demographics, clinical history, reason for testing, genetic test codes, and any relevant family history must be reported on a molecular genetics test request.

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