Get the free Cancer genetics referral form - Orillia Soldiers' Memorial ...

NORTH SIM COE MUSKOX REGIONAL GENETICS PROGRAM CANCER GENETICS REFERRAL FORM Please fax form to: (705) 3259459Telephone: (705) 3279154PATIENT INFORMATION Last name: First Name: DOB: (BY/MM/DD) Male

How to fill out cancer genetics referral form

How to fill out cancer genetics referral form

1. When filling out a cancer genetics referral form, follow these steps:
2. Start by filling out the patient's demographic information such as name, age, and contact details.
3. Provide relevant medical history including any past cancer diagnoses, family history of cancer, and other related health conditions.
4. Include the reason for referral and the type of cancer suspected or being explored.
5. Specify any specific genetic testing requested and provide any relevant supporting documentation.
6. Add information about any genetic counseling or testing already undergone by the patient.
7. Include relevant clinical notes, pathology reports, and imaging documents if available.
8. Provide the name and contact information of the referring healthcare provider.
9. Review the form for accuracy and completeness before submitting it.

Who needs cancer genetics referral form?

1. Cancer genetics referral forms are needed for individuals who meet certain criteria such as:
2. - Individuals with a personal history of cancer who may benefit from genetic testing to assess their risk of developing additional cancers.
3. - Individuals with a family history of cancer, particularly when multiple family members have been affected or there are cases of cancer at a young age.
4. - Individuals with specific types of cancer that are known to have a higher genetic component, such as breast, ovarian, colorectal, or pancreatic cancer.
5. - Individuals who have already undergone genetic testing and need further evaluation or genetic counseling.
6. - Individuals who have been diagnosed with a rare or unusual cancer that may have a genetic basis.
7. - Individuals who are interested in understanding their genetic risk for cancer and exploring preventative measures.

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What is cancer genetics referral form?

Cancer genetics referral form is a document used to refer individuals to genetic counseling and testing to assess their risk of developing hereditary cancer.

Who is required to file cancer genetics referral form?

Healthcare providers, such as doctors, nurses, and genetic counselors, are usually required to file the cancer genetics referral form on behalf of their patients.

How to fill out cancer genetics referral form?

The form typically requires information about the patient's medical history, family history of cancer, and any known genetic mutations. Healthcare providers can fill out the form electronically or on paper.

What is the purpose of cancer genetics referral form?

The purpose of the cancer genetics referral form is to identify individuals who may benefit from genetic counseling and testing for hereditary cancer risk.

What information must be reported on cancer genetics referral form?

Information such as patient demographics, medical history, family history of cancer, and any relevant genetic testing results should be included on the cancer genetics referral form.