Nipt test form 2026

The document is a Patient History Form for Non-Invasive Prenatal Testing (NIPT) provided by ARUP Laboratories. It collects essential patient information, including demographics, gestational details, and reasons for testing. The NIPT aims to screen for chromosomal abnormalities such as Trisomy 21, 18, and 13, as well as Turner syndrome. It emphasizes that the test is not diagnostic and outlines the potential results and limitations of the screening. Informed consent is required from the patient or guardian before proceeding with the test.

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Click ‘Get Form’ to open the NIPT test form in the editor.
Begin by entering your Patient Name and Date of Birth in the designated fields. Ensure accuracy as this information is crucial for identification.
Fill in the Physician/Genetic Counselor's name and contact details, including phone and fax numbers, to facilitate communication.
Indicate your Due Date (EDD) and select the Fetal Gender by checking the appropriate box. If you wish to know the gender, ensure you check 'I wish to know the fetal gender'.
Complete your current weight and race selections. If applicable, indicate if you are carrying more than one fetus.
Answer questions regarding genetic motherhood and testing indications by checking all relevant boxes.
If a cheek swab from the father will accompany your sample, provide his name and date of birth.
Review the informed consent section carefully, ensuring you understand all points before signing at the bottom of the form.

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Do I need a referral for a NIPT test?

Your GP or Obstetrician is the best place to start, ask for a referral for an NIPT test and then we can book you an appointment for a pre-NIPT ultrasound scan and blood collection.

Can we do a NIPT test at home?

Is a home sample collection available for the NIPT test? Yes, Orange Health Labs does provide doorstep sample collection for NIPT testing. After scheduling the test, a trained eMedic expert will come to your location within 60 minutes to collect the required sample.

What is required for a NIPT test?

The NIPT looks at these fragments of fetal DNA in your blood known as cell-free DNA or cfDNA. Your provider obtains a blood sample through a vein in your arm. They send this sample to a lab to analyze it for specific conditions.

How much does NIPT cost?

The cost of NIPT can vary docHubly based on several factors. In the U.S., for instance, the cost can range from $100 to over $2,000. In other countries, the price might be different, depending on healthcare infrastructure, insurance coverage, and the prevalence of private vs.