Get the free Clinical Genomics Test Requisition Form - Ambry Genetics
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HTTPS://www.firmalab.com Tel: (818) 7891033 Fax: (818) 7891033TEST REQUISITION FORM (DNA & GENETIC TESTS) INCLUDE THE FIRST 3 PAGES OF THIS FORM WITH SPECIMEN. Before sending specimens, please contact
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How to fill out clinical genomics test requisition
How to fill out clinical genomics test requisition
01
Obtain a clinical genomics test requisition form from the appropriate healthcare provider or laboratory.
02
Fill out the patient information section, including full name, date of birth, and contact information.
03
Provide relevant medical history and any symptoms or concerns that may assist in the interpretation of the test results.
04
Specify the type of genetic test required and the reason for ordering it.
05
Include information about the referring healthcare provider, such as their name, contact information, and specialty.
06
If applicable, include insurance information, as some genetic tests may require pre-authorization or may have coverage limitations.
07
Ensure that all sections on the requisition form are completed accurately and legibly.
08
Review the completed form for any errors or missing information before submitting it.
09
Submit the filled-out requisition form to the appropriate laboratory or healthcare provider as instructed.
Who needs clinical genomics test requisition?
01
Clinical genomics test requisitions are typically needed by healthcare providers, such as doctors or genetic counselors, who are requesting genetic testing for their patients.
02
These requisitions may also be required by individuals who wish to pursue genetic testing directly, although it is advisable to consult with a healthcare professional to determine the appropriateness and interpretation of the test results.
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