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NORTHWEST CLINICAL GENOMICS LABORATORY
1959 NE PACIFIC AVE., LAB H561, SEATTLE, WA 98195
PHONE: 2065430459; FAX: 2066161899 www.uwcpdx.orgEXOME TEST REQUISITION AND CONSENT FORM
HEALTHCARE PROVIDERPATIENT
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How to fill out exome test requisition and
How to fill out exome test requisition and
01
Ask your healthcare provider for an exome test requisition form.
02
Fill out your personal information accurately, including your name, date of birth, and contact information.
03
Provide information about your medical history and any relevant family history of genetic conditions.
04
Follow any specific instructions provided on the requisition form for sample collection or test preparation.
05
Submit the completed requisition form to the designated laboratory for processing.
Who needs exome test requisition and?
01
Individuals with suspected genetic disorders that have not been diagnosed through traditional testing methods.
02
Individuals with a family history of genetic conditions who are seeking information about their own genetic risk.
03
Research institutions or healthcare providers looking to conduct genetic testing for research purposes.
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What is exome test requisition and?
Exome test requisition is a form or request used to order an exome sequencing test for a patient.
Who is required to file exome test requisition and?
Healthcare providers or genetic counselors are required to file exome test requisition.
How to fill out exome test requisition and?
To fill out an exome test requisition, the healthcare provider needs to provide patient information, reason for testing, and relevant medical history.
What is the purpose of exome test requisition and?
The purpose of exome test requisition is to order a comprehensive genetic test to identify potential disease-causing mutations in a patient's exome.
What information must be reported on exome test requisition and?
Information such as patient demographics, family history, clinical symptoms, and genetic counseling notes must be reported on exome test requisition.
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