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How to fill out the Harmony Test Form online
The Harmony Test Form is essential for requesting a Non-Invasive Prenatal Test. This guide provides clear, step-by-step instructions to help you complete the form online with confidence and clarity.
Follow the steps to successfully complete the Harmony Test Form online:
- Press the ‘Get Form’ button to obtain the form and open it in an online editor.
- Fill in the requesting doctor’s details, including their name and address, which are required for the request.
- Input the patient details. Provide the patient's first name, surname, date of birth, gender, and phone number. Ensure their provider number is also entered.
- The doctor must confirm the patient has been counseled about the test by signing and providing their mobile phone and date.
- Indicate where to send the test results by filling in the name and address for report distribution.
- Select the tests requested, making sure to choose between the singleton or twin Harmony Prenatal Test and specify the fetal gender if applicable.
- Complete the clinical information section by entering any previous lab ID and consent status regarding auditing of results.
- Provide the gestational age by entering the relevant weeks and days based on the last menstrual period or estimated due date.
- The patient must consent to the test by signing and dating the form.
- For the collector, provide maternal information such as weight and height; include signatures and relevant details for the specimen collection.
- Finally, finalize the order by visiting the payment link provided to complete the booking and payment process. Ensure to save, download, print, or share the filled-out form as needed.
Complete your Harmony Test Form online today to ensure a smooth testing process.
The Harmony® prenatal test is a type of non-invasive prenatal test (NIPT), which can also be called NIPS (non-invasive prenatal screening). It looks at fragments of your baby's DNA in your blood to provide accurate information about the likelihood for the most common chromosomal conditions as early as 10 weeks.
Fill Harmony Test Form
Confirm pre-payment prior to collection. • Add the Receipt Number to box on right hand side. The test provides a risk assessment, not a. Instructions: Please complete Patient Information and Indication Category I or II sections of the form, and attach to the completed HarmonyTM Prenatal Test. Harmony test(s) selected on this form, TDL Genetics Limited may store your personal data (including the test results) and remaining sample (if any) for the. The Harmony Prenatal Test with X and Y analysis is a screening test and offers evaluation for chromosomes X and Y in addition to chromosomes 21, 18, and 13.
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