Get Cigna Genetic Counseling Form

Filling out the Cigna Genetic Counseling Form online is an important step in initiating genetic testing and counseling services. This guide provides clear, step-by-step instructions to ensure that you complete the form accurately and efficiently.

Follow the steps to fill out the Cigna Genetic Counseling Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Provide your information in the 'Customer (Patient) Information' section. Fill in your name, ID number, date of birth, and date of consultation accurately.
3. In the 'Genetic Clinical Nurse, Advanced Practice Nurse in Genetics, Genetic Counselor or Clinical Geneticist Information' section, enter the professional’s details, including their name, address, tax ID, telephone, and fax information.
4. Next, input the details of the 'Ordering Healthcare Professional' in the corresponding fields, including their name, address, telephone, and fax number.
5. In the 'Rendering Lab Information' section, provide the laboratory's name, address, telephone, and fax information.
6. Enter the requested test names in the 'Requested Test(s) Information' section. Ensure you input the correct CPT or HCPCS codes as well.
7. Choose one recommendation from the options provided in the 'Recommendation' section. Be sure to include any necessary explanations if your choice requires it.
8. Affirm that you are a qualified professional by checking the appropriate box, and provide your signature and date as required.
9. Ensure you have gathered all necessary documents as specified in the submission instructions. This includes a 3-generation pedigree, a copy of the Ordering HCP’s Lab Requisition Form, and a photocopy of your evaluation.
10. Once all sections are completed, save your changes, and prepare to fax the completed form along with the supporting documents to Cigna at 855.245.1104.

Complete the Cigna Genetic Counseling Form online today to initiate your genetic counseling process.