Get Invitae Requisition Form

The Invitae Requisition Form is essential for ordering genetic tests and provides necessary patient information. This guide will assist you in accurately completing the form online, ensuring a smooth process for both patients and medical professionals.

Follow the steps to complete the Invitae Requisition Form effectively.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Begin by filling out the patient information section. Enter the patient's first name, middle initial, last name, date of birth, sex, and address. Make sure to include the medical record number (MRN) and email address for report access.
3. In the practice information section, provide the practice name, address, phone number, and the primary clinical contact's details including their name, role, and email address.
4. Next, proceed to the specimen information section. Ensure that each specimen tube is labeled with the patient's full name, date of birth, and the specimen collection date. Specify the type of specimen collected (blood, saliva, etc.) and indicate any special cases.
5. In the reason for testing section, include any relevant ICD-10 codes and specify the ordering physician's details. If the ordering physician is the same as the primary clinical contact, simply check the designated box.
6. If applicable, add any additional clinical or laboratory contacts and check if you have attached a Letter of Medical Necessity (LMN) for insurance billing.
7. Complete the billing information section, indicating whether Medicare or any other insurance is the primary or secondary payer. Attach any necessary documentation related to insurance billing.
8. Lastly, complete the form by signing and dating it to confirm that all provided information is accurate and that consent has been obtained. Review your entries for accuracy and ensure all required fields are completed.
9. After filling out the form, you can save your changes, download, print, or share the form as needed.

Complete the Invitae Requisition Form online today for a streamlined process.