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This document serves as a requisition form for the MaterniT® Prenatal Test, which provides non-invasive prenatal testing to assess the risk of certain chromosomal conditions in the fetus. It includes sections for patient and prescriber information, options for testing, and informed consent related to the limitations and scope of the testing. Patients must be at least 9 weeks gestational age for the test to be performed, and results are intended to be discussed with a healthcare provider.

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How to fill out maternit prenatal test requisition

01

Obtain the Maternit prenatal test requisition form from your healthcare provider.

02

Fill in the patient's full name, date of birth, and contact information.

03

Indicate the expected due date and any relevant medical history.

04

Provide information on the patient's insurance details, if applicable.

05

Check the appropriate box for the type of test requested.

06

Sign and date the form to confirm accuracy.

07

Submit the completed requisition to the designated laboratory or healthcare facility.

Who needs maternit prenatal test requisition?

01

Pregnant individuals who are at risk for genetic conditions.

02

Patients with a family history of genetic disorders.

03

Women over the age of 35 who are pregnant.

04

Individuals who have had abnormal results in prior prenatal tests.

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What is maternit prenatal test requisition?

The maternit prenatal test requisition is a document used to request genetic testing during pregnancy to assess the risk of certain genetic conditions in the fetus.

Who is required to file maternit prenatal test requisition?

Typically, healthcare providers, such as doctors or midwives, are required to file the maternit prenatal test requisition on behalf of the pregnant individual.

How to fill out maternit prenatal test requisition?

To fill out the maternit prenatal test requisition, a healthcare provider must provide information such as the patient’s personal details, medical history, and specific tests requested.

What is the purpose of maternit prenatal test requisition?

The purpose of the maternit prenatal test requisition is to identify potential genetic abnormalities in a developing fetus, allowing for informed decision-making and early intervention if necessary.

What information must be reported on maternit prenatal test requisition?

The requisition must report information such as the patient's name, date of birth, medical history, gestational age, and specific tests requested.

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