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Carrier Screening Test Requisition GTM LABORATORYDATE & TI M E RECEIVED:SPECIMEN ID:ACCESSION NO:USE ONLY:1. PATIENT INFORMATION (REQUIRED) First Name Last Name DOB(mm/dd/YYY) Male Female Age Address
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How to fill out carrier screening test requisition

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How to fill out carrier screening test requisition

01
Start by obtaining the carrier screening test requisition form from a genetic counselor or healthcare provider.
02
Carefully read and understand the instructions provided on the form.
03
Fill out your personal information accurately, including your name, date of birth, and contact information.
04
Provide information about your partner, including their name and contact information if applicable.
05
Indicate the reason for the carrier screening test, which could be pregnancy planning or personal knowledge.
06
Specify any specific genetic disorders or conditions you would like to be screened for.
07
Follow the instructions regarding sample collection, which may involve a blood test or a saliva swab.
08
Make sure to sign and date the form to validate it.
09
Submit the completed carrier screening test requisition form to the designated healthcare facility or laboratory according to the specified instructions.

Who needs carrier screening test requisition?

01
The carrier screening test requisition is typically needed by individuals or couples who are planning to have children or are already pregnant.
02
It is recommended for anyone with a family history of genetic disorders or conditions, individuals belonging to certain ethnic or racial groups with higher carrier frequencies, or those who simply want to gain insights into their potential risk of passing on genetic conditions to their offspring.
03
It is advisable to consult with a genetic counselor or healthcare provider to determine if carrier screening is appropriate for your specific situation.
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Carrier screening test requisition is a request to perform genetic testing on individuals to identify if they carry specific genetic mutations that could be passed on to their offspring.
Healthcare providers or genetic counselors are usually required to file carrier screening test requisitions on behalf of their patients.
Carrier screening test requisitions can be filled out by providing information about the patient, their medical history, and reasons for requesting the test.
The purpose of carrier screening test requisition is to identify individuals who may be carriers of genetic mutations that could impact their future children.
Information such as patient demographics, family history of genetic conditions, and reason for the test must be reported on carrier screening test requisition.
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