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CYTOGENOMICS TEST REQUISITION FORM All sections on this page are required unless otherwise specified. Important fields are highlighted. Incomplete information could result in a delay of testing. PATIENT
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How to fill out genetic testing and screening

01
Speak to a healthcare provider to discuss the need for genetic testing and screening.
02
Obtain a referral if necessary.
03
Schedule an appointment with a genetic counselor or healthcare professional specialized in genetic testing.
04
Provide a detailed family history including any known genetic conditions or diseases.
05
Follow any instructions given by the healthcare provider or genetic counselor regarding sample collection or testing process.
06
Wait for the results and ask for interpretation and guidance from the healthcare provider.

Who needs genetic testing and screening?

01
Individuals with a family history of genetic conditions or diseases.
02
People with a personal history of genetic disorders or birth defects.
03
Individuals from certain ethnic backgrounds with a higher risk of genetic conditions.
04
Couples planning to have children who want to assess genetic risk.
05
Patients with certain health conditions that may benefit from genetic testing for tailored treatment.
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Genetic testing and screening involve analyzing DNA to identify genetic disorders, predispositions to diseases, or the likelihood of passing on genetic conditions.
Generally, individuals seeking to understand their genetic predispositions or those undergoing certain medical evaluations may be required to file genetic testing and screening.
To fill out genetic testing and screening, individuals must complete specific forms that provide personal and family health history, indicate reasons for testing, and consent to the genetic analysis.
The purpose of genetic testing and screening is to identify inherited conditions, inform medical treatment decisions, enable proactive health management, and facilitate family planning.
Information that must be reported includes the individual's identity, test results, family history, reasons for testing, and any relevant medical history.
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