Get Dna Analysis Request Form - University College London Hospitals

Completing the DNA Analysis Request Form for University College London Hospitals is an essential step for initiating genetic testing. This guide provides comprehensive, step-by-step instructions on how to accurately fill out the online form, ensuring that all required information is properly submitted.

Follow the steps to successfully complete the DNA Analysis Request Form.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Fill in your surname and forename(s). Ensure accuracy as this information is critical for identification and correspondence.
3. Enter the date of birth, using the format requested to avoid any confusion.
4. Select your gender by ticking the appropriate box.
5. Provide your address including the post code to facilitate communication regarding your request.
6. Indicate the name of your general practitioner (GP) for any necessary consultations.
7. If applicable, state whether there is a genetic investigation in your family. If yes, provide names, relationships, and dates of birth of relatives as requested.
8. Fill in your hospital number and NHS number if available, to link your request with your medical records.
9. Provide the date and time the sample was taken and when it was received at the laboratory.
10. Specify the referring hospital and the name of the consultant involved in your care.
11. Select your ethnic origin by ticking the appropriate box.
12. Indicate the priority of your request: urgent or routine.
13. Provide the email address for receiving the report, ensuring that it is an NHS.NET address for compliance.
14. Fill in the address where the report should be sent if it differs from your main address.
15. Complete the purchase order number and billing address if they are different from the report address.
16. Select the sample type you are submitting by ticking the relevant box, including options for blood, muscle, urine, and other types.
17. Choose the reason for the referral and provide detailed relevant clinical details or pedigree if necessary.
18. Ensure the consent statement is signed by the referring clinician, confirming that consent for testing and storage has been obtained.
19. Save your changes carefully, and you may download, print, or share the completed form.

Complete your DNA analysis request form online today to ensure timely processing of your genetic testing needs.