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GENETIC TESTING
REFERRAL WORKSHEET
Toll free Phone Number: 18888912520
Fax Number: 5676610846 or Toll free: 8442824906
Attention: Genetic Testing Red Coordinator
Date of Request:
Member Name:
Member
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What is genetic testing referral worksheet?
A genetic testing referral worksheet is a document used by healthcare providers to gather and submit necessary information about a patient who is being referred for genetic testing.
Who is required to file genetic testing referral worksheet?
Healthcare providers or clinicians who are referring patients for genetic testing are required to file the genetic testing referral worksheet.
How to fill out genetic testing referral worksheet?
To fill out a genetic testing referral worksheet, a provider should complete sections that require patient information, medical history, family history, and the specific tests being requested. It's important to ensure all fields are accurately filled in.
What is the purpose of genetic testing referral worksheet?
The purpose of the genetic testing referral worksheet is to facilitate the collection and organization of relevant patient information to ensure appropriate genetic testing is conducted and interpreted accurately.
What information must be reported on genetic testing referral worksheet?
The worksheet must report patient demographic information, medical and familial history, reasons for referral, specific genetic tests requested, and any other pertinent clinical information.
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