Follow the steps to fill out the application accurately.

1. Click ‘Get Form’ button to receive the application form and open it in your preferred online editor.
2. Start by filling in your personal information. This includes your first name, last name, middle initial, date of birth (in MM/DD/YYYY format), address, city, state, and zip code. Make sure to review this information for accuracy.
3. Provide your email address to ensure that Baylor Genetics can communicate with you regarding your application.
4. Input information about your health insurance. List the primary insurance company name. Ensure that you qualify based on the requirement of having health care insurance.
5. State your total annual gross household income and the number of people in your household. Reference the financial assistance scale to confirm that your income meets the eligibility criteria.
6. Indicate the test code ordered as related to your genetic testing needs. This helps Baylor Genetics understand the specific tests you require.
7. Complete the attestation section. Read the statements carefully and certify that the information you have provided is true and accurate. Sign and date the form in the designated areas.
8. Gather the necessary supporting documentation as specified. This may include your most recent IRS 1040 tax form, recent pay stubs, unemployment information, or any other documentation that demonstrates your financial situation.
9. Once you have filled out the application and attached the required documentation, save your changes. Then, download, print, or share the completed form as necessary.

Complete the Baylor Genetics Patient Assistance Program & Application online now to ensure you receive the financial assistance you may need.