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Get the free prenatal genetics test requisition form - GeneDx

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Carrier Screening Test Requisition GTM LABORATORYDATE & T I 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 prenatal genetics test requisition

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How to fill out prenatal genetics test requisition

01
Obtain the prenatal genetics test requisition form from your healthcare provider or genetic counselor.
02
Fill out the patient's personal information section, including their name, date of birth, and contact information.
03
Provide details about the pregnancy, such as the gestational age and any relevant medical history.
04
Indicate the specific tests you are requesting by checking the corresponding boxes or writing them in.
05
If necessary, include any special instructions or additional information in the designated section.
06
Sign and date the requisition form to authorize the tests.
07
Make a copy of the completed form for your records, if desired.
08
Submit the requisition form to the appropriate laboratory or testing center as instructed by your healthcare provider.
09
Follow any further instructions provided by the laboratory or testing center regarding sample collection or scheduling of the tests.
10
Keep a copy of the requisition form and any associated documentation for future reference.

Who needs prenatal genetics test requisition?

01
Prenatal genetics test requisition may be needed by pregnant individuals who want to assess their risk of having a baby with genetic conditions or birth defects.
02
It is commonly used by individuals with a personal or family history of genetic disorders, couples with a previous child with a genetic condition, or those with advanced maternal age.
03
Additionally, healthcare providers may recommend prenatal genetics testing for individuals who have abnormal results from routine prenatal screenings or specific risk factors identified during pregnancy.
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It is a form or request that is used to order genetic testing for a fetus during pregnancy.
Healthcare providers or individuals who want to undergo genetic testing during pregnancy.
The requisition form typically includes patient information, reason for testing, type of test requested, and healthcare provider's information.
The purpose is to determine the genetic makeup of the fetus, identify any potential genetic disorders or abnormalities, and provide information for medical decision-making.
Patient demographic information, reason for testing, type of test requested, healthcare provider details.
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