Welcome New Patients!
• Please complete any forms requested with your online appointment offer
• The following forms should take 5 to 10 minutes to complete, and are easily submitted online here.
• Don’t forget to schedule your appointment.
2. Family History Questionnaire to assist in cancer testing
3. Client Intake and Consent Form — Individuals (optional for clients referred by genetic testing laboratories)
4. Cancer Risk Assessment Form ( For cancer-related, 23andme, ancestry or exome testing)
5. ONLY IF WE ARE BILLING YOUR INSURANCE: (e-mail phone photo of both sides of insurance card to firstname.lastname@example.org You may also fax a copy to 888-204-5975)
6. NIPT History Questionnaire (Non-invasive prenatal testing — only if this applies)
Other items may be required in the future upon our request to you:
- Medical Records Request (We will let you know during your first appointment, whether any records are necessary). If you are seeking genetic counseling on the results of a relative, please print this, have your relative sign, and return to us by secure fax number below.
- Pediatric Appointment
- Cancer Screening Risk Assessment appointment forms
- Adult appointment
- Prenatal appointment
- DNA testing forms