PATIENT HISTORY FORM FOR NON-INVASIVE PRENATAL TESTING (NIPT) 2026

1. Click ‘Get Form’ to open the PATIENT HISTORY FORM FOR NON-INVASIVE PRENATAL TESTING (NIPT) in our editor.
2. Begin by entering your Patient Name and Date of Birth at the top of the form. This information is crucial for identification.
3. Fill in the Physician/Genetic Counselor's details, including their Phone and FAX numbers, ensuring accurate communication.
4. Indicate the Draw Date and Gestational Age at Draw. Select the Fetal gender by checking the appropriate box: Male, Female, or Ambiguous.
5. Provide your current weight and select your race from the options provided. If you are carrying more than one fetus, indicate this as well.
6. Check all applicable indications for testing. This section helps clarify why you are seeking NIPT.
7. If applicable, include the father’s name and date of birth for additional context regarding testing requirements.
8. Review all sections carefully before submitting to ensure accuracy. Use our platform's features to save or share your completed form easily.

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