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Consent Form for Diagnostic Molecular Genetic Testing - Our

Consent Form for Diagnostic Molecular Genetic Testing - Our 2025

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The document is a consent form for diagnostic genetic testing for Huntington Disease (HD) from the Genetics Laboratory at Our Lady’s Children’s Hospital in Dublin, Ireland. It outlines the purpose of the test, potential outcomes, and requirements for patient information and consent. It also includes provisions for cases where a patient may lack the capacity to consent, emphasizing the importance of considering family input in such situations.

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Click ‘Get Form’ to open it in the editor.
Begin by filling in your First Name(s) and Surname using BLOCK CAPITALS. This ensures clarity and legibility.
Enter your Hospital Number and Date of Birth (DOB) accurately, as these details are crucial for identification.
Provide your Home Address, ensuring all information is complete for correspondence purposes.
Fill in the DCG Pedigree Number if applicable, followed by your SEX.
Complete the Consultant/GP section with the relevant ward, clinic, or surgery address and contact number.
Sign the form as the patient to confirm consent for testing. If applicable, medical staff should select option (a) or (b) regarding capacity to consent and provide their signature along with their name in capitals and contact phone number.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Do you need a consent form for genetic testing?

Note to the Ordering Health Care Provider: Some states require that patients (or their authorized representatives) provide their written informed consent prior to receiving genetic testing, and that the ordering health care provider maintain documentation of the informed consent in the patients medical record.

What type of testing needs a consent form?

Yes, a referral is needed. If you have had a biopsy test, the biopsy center director should refer you. However, any licensed physician or genetic counselor may make the referral.

Does genetic testing require informed consent?

In general, most of the original clinical genetic testing laws paired requirements for informed consent with protections against non-consensual use of genetic information.

How do you get informed consent for a genetic analysis?

Before a person has a genetic test, it is important to fully understand the testing procedure, the benefits and limitations of the test, and the possible consequences of the test results. The process of educating a person about the test and obtaining permission to carry out testing is called informed consent.

Does genetic testing require authorization?

What does the laboratory need to do to process a genetic test? The laboratory must verify that the prior authorization request has been approved and receive the transaction number before processing any specimens. Failure to do so will impact reimbursement.