UNMC Prenatal and Pregnancy Loss Microarray Test Request Form 2012 free printable template

HU MAN GE NE TICS LAB ORATORY www.unmc.edu/geneticslab/ CAP Accredited CIA# 28DO454363 PREGNANCY LOSS MICROARRAY Test Request Form PATIENT INFORMATION Name: DOB: Address: City: Phone: Med. Record

How to fill out UNMC Prenatal and Pregnancy Loss Microarray

How to fill out UNMC Prenatal and Pregnancy Loss Microarray Test

1. Obtain the UNMC Prenatal and Pregnancy Loss Microarray Test requisition form from the designated healthcare provider or UNMC website.
2. Fill in patient information, including full name, date of birth, and insurance details.
3. Provide detailed clinical information, including the reason for testing, such as prenatal screening or history of pregnancy loss.
4. Collect the required biological specimens (e.g., amniotic fluid, chorionic villus samples, or fetal tissue) in accordance with the guidelines provided with the requisition form.
5. Ensure that all specimens are properly labeled with patient identification and collected in the appropriate containers.
6. Complete any necessary consent forms ensuring the patient understands the testing process and implications.
7. Submit the completed requisition form and specimens to the designated laboratory facility for processing.
8. Await results, which typically involve follow-up with a healthcare provider to discuss findings and implications.

Who needs UNMC Prenatal and Pregnancy Loss Microarray Test?

1. Individuals undergoing prenatal testing due to advanced maternal age, family history of genetic disorders, or abnormal prenatal screening results.
2. Pregnant individuals who have experienced recurrent pregnancy loss or have had a previous fetus with a known chromosomal abnormality.
3. Couples with a history of infertility or those who have previously had children with developmental delays or congenital anomalies.

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What is UNMC Prenatal and Pregnancy Loss Microarray Test?

The UNMC Prenatal and Pregnancy Loss Microarray Test is a genetic testing method used to identify chromosomal abnormalities in prenatal samples or in cases of pregnancy loss. It utilizes microarray technology to assess the genome for deletions, duplications, and other genetic variations that may affect fetal development.

Who is required to file UNMC Prenatal and Pregnancy Loss Microarray Test?

Healthcare providers and genetic counselors typically file the UNMC Prenatal and Pregnancy Loss Microarray Test on behalf of their patients when there is a clinical indication of potential genetic issues such as abnormal ultrasound findings, family history of genetic disorders, or unexplained pregnancy loss.

How to fill out UNMC Prenatal and Pregnancy Loss Microarray Test?

To fill out the UNMC Prenatal and Pregnancy Loss Microarray Test requisition form, healthcare providers must provide patient demographics, clinical history, indication for testing, specimen information, and any relevant family history. Accurate completion of the form is crucial for timely processing and interpretation of results.

What is the purpose of UNMC Prenatal and Pregnancy Loss Microarray Test?

The purpose of the UNMC Prenatal and Pregnancy Loss Microarray Test is to detect genetic abnormalities that may contribute to developmental issues, congenital defects, or pregnancy loss. It helps in providing valuable information for diagnosis, management, and counseling for affected pregnancies.

What information must be reported on UNMC Prenatal and Pregnancy Loss Microarray Test?

The information reported on the UNMC Prenatal and Pregnancy Loss Microarray Test includes the patient's details, specimen type, testing results, identified genetic abnormalities or variants, and recommendations for further testing or clinical follow-up if necessary.