Requestor (s) 2025

1. Click ‘Get Form’ to open the Requestor(s) document in the editor.
2. Begin by filling out the patient information section, including Last Name, First Name, Date of Birth, and Gender. Ensure all fields are completed accurately.
3. In the Requestor Name section, provide the name of the healthcare provider and any additional contacts as needed. Include their respective phone numbers for easy communication.
4. Complete the specimen type selection by checking the appropriate box for Whole Blood, Extracted DNA, or other specified types. If prenatal testing is indicated, ensure maternal samples are noted.
5. Fill out Section I regarding the reason for testing by selecting one option that best describes the patient's situation. This helps streamline processing.
6. Provide detailed patient clinical information in Section III, including any relevant medical history such as blood transfusions or current treatments.
7. If applicable, complete Sections V and VI for specific variant testing requests and cancer/endocrine panel requests. Be sure to reference any previous test results if necessary.

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