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CTT 6575 Snowdrift Road, Suite 106, Allentown, PA 18106 Phone: (484) 2442900 Fax: (484) 2442904 www.ctgt.net (CIA# 39D1027912 CAP# 7190738 NPI# 1952866824)TARGETED VARIANT TEST REQUISITION FORM Please
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How to fill out targeted variant test requisition

01
Start by gathering all the required information and materials for the targeted variant test requisition.
02
Fill out the patient's demographic information accurately, including their name, date of birth, gender, and contact details.
03
Provide the relevant medical history of the patient, including any previous genetic testing or relevant medical conditions.
04
Specify the reason for the targeted variant test requisition, including the suspected genetic disorder or specific genes to be tested.
05
Clearly indicate the healthcare professional's information, including their name, contact details, and signature.
06
Attach any supporting documents, such as medical records or genetic counseling reports, if necessary.
07
Double-check all the entered information to ensure accuracy and completeness.
08
Submit the targeted variant test requisition form to the designated laboratory or genetic testing facility as instructed.
09
Follow any additional instructions or requirements provided by the laboratory or genetic testing facility regarding sample collection or shipping.
10
Await the results of the targeted variant test and communicate with the healthcare professional for further guidance and interpretation.

Who needs targeted variant test requisition?

01
The targeted variant test requisition is needed by healthcare professionals, such as medical geneticists, genetic counselors, or treating physicians.
02
It is required when there is a suspicion of a genetic disorder or when specific genes need to be analyzed to aid in diagnosis, treatment, or genetic counseling.
03
Patients who have a family history of known genetic conditions or individuals with symptoms suggestive of a specific genetic disorder may also require a targeted variant test requisition.
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A targeted variant test requisition is a specific request form used to identify and analyze particular genetic variants in a patient's sample.
Healthcare providers, including physicians and genetic counselors, who are conducting genetic testing on patients are required to file the targeted variant test requisition.
To fill out a targeted variant test requisition, provide patient information, specify the genetic variant being tested, and include relevant clinical information and medical history.
The purpose of the targeted variant test requisition is to ensure that genetic testing focuses on specific variants of interest, aiding in accurate diagnosis, treatment planning, and patient management.
The requisition must report patient demographics, reason for testing, specific variants of interest, relevant medical history, and any previous genetic testing results.
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