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Click ‘Get Form’ to open it in the editor.
Begin by entering the owner's name and contact information in the designated fields. Ensure that all details are accurate and legible.
If applicable, provide the veterinarian's account number and clinic information. This is essential for samples submitted under a licensed veterinarian's account.
Fill in the dog’s information, including breed, sex, color/markings, call name, date of birth, registered name, registration number, and microchip/tattoo number. Make sure to complete all required fields.
Indicate how you would like the results returned—via fax, email, or postal service—by selecting your preferred option.
Finally, review all entered information for accuracy before submitting. Remember that payment must accompany your sample for processing.

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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.

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.

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.

Can an employer ask for genetic information?

No. It is illegal for your employer to ask you about genetic information during an interview. For example, your employer may not ask you if you have any relatives who have bipolar disorder or other psychiatric conditions.

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.