Get the free GENETICS CLINIC REFERRAL FORM - Ottawa
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HEREDITARY CANCER Requisition STAMPS hip to:Genetics Diagnostic Laboratory Regional Genetics Program 401 Smith Road, Rm w3401 Ottawa, ON, K1H 8L1 Tel: (613) 7383230 Fax: (613) 7384814 http://www.cheo.on.ca/en/clinicsservicesprograms/geneticsdiagnosticlaboratory.aspxALL
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How to fill out genetics clinic referral form
How to fill out genetics clinic referral form
01
Obtain the genetics clinic referral form from the clinic or download it from their website.
02
Fill out the patient's personal information including 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 and any specific concerns or symptoms that need to be addressed.
05
Sign and date the form before submitting it to the genetics clinic.
Who needs genetics clinic referral form?
01
Patients who suspect they have a genetic condition and want to undergo genetic testing.
02
Healthcare providers who want to refer a patient to a genetics clinic for further evaluation and management of a genetic disorder.
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What is genetics clinic referral form?
Genetics clinic referral form is a document used to refer individuals to a genetics clinic for evaluation and testing.
Who is required to file genetics clinic referral form?
Healthcare providers, genetic counselors, or other professionals who suspect a genetic condition in a patient may be required to file the genetics clinic referral form.
How to fill out genetics clinic referral form?
To fill out the genetics clinic referral form, provide all relevant patient information, family history, and reasons for the referral. Make sure to include any relevant medical records or test results.
What is the purpose of genetics clinic referral form?
The purpose of genetics clinic referral form is to facilitate the referral process for individuals suspected of having a genetic condition, ensuring they receive proper evaluation and testing.
What information must be reported on genetics clinic referral form?
The genetics clinic referral form must include the patient's personal information, family history, medical history, reasons for referral, and any relevant medical records or test results.
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