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CLINICAL GENETICS REFERRAL FORM 2200 Clinton Ave W, Mississauga, ON L5M 2N1 Phone Number: 9058134104 Fax Number: 9058134347 The referral will be processed more efficiently if all relevant medical
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How to fill out clinic genetics referral form
How to fill out clinic genetics referral form
01
Obtain the clinic genetics referral form from the clinic or healthcare facility.
02
Fill out the patient's personal information such as name, date of birth, address, and contact information.
03
Provide details about the patient's medical history and any relevant family history of genetic conditions.
04
Include information about the reason for the referral to the genetics clinic and any specific concerns or questions.
05
Make sure to sign and date the form before submitting it to the genetics clinic.
Who needs clinic genetics referral form?
01
Individuals who suspect they may have a genetic condition or those with a family history of genetic disorders may need a clinic genetics referral form.
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What is clinic genetics referral form?
Clinic genetics referral form is a document used to refer a patient to a genetics clinic for evaluation and testing.
Who is required to file clinic genetics referral form?
Healthcare providers, such as doctors or genetic counselors, are required to file clinic genetics referral form.
How to fill out clinic genetics referral form?
Clinic genetics referral form can be filled out by providing patient information, medical history, reason for referral, and any relevant test results.
What is the purpose of clinic genetics referral form?
The purpose of clinic genetics referral form is to facilitate the referral process for patients who may benefit from genetic counseling or testing.
What information must be reported on clinic genetics referral form?
Information such as patient demographics, family history of genetic conditions, and reason for referral must be reported on clinic genetics referral form.
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