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Get Nemours Next Generation Sequencing (ngs) Panel Sample Submission 2019-2026
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How to fill out the Nemours Next Generation Sequencing (NGS) Panel Sample Submission online
This guide provides clear and detailed instructions on how to fill out the Nemours Next Generation Sequencing (NGS) Panel Sample Submission form online. By following these steps, users will be able to complete the submission process efficiently and accurately.
Follow the steps to complete your sample submission form.
- Click ‘Get Form’ button to obtain the form and open it for editing.
- Begin by filling out the patient information section. Enter the patient’s name in the format of last name followed by first name, select the biologic sex, and provide the date of birth using the MM/DD/YYYY format.
- Continue with the medical record number, collection date, and select the sample type from the available options: Blood, DNA, Buccal swab, or Other (please specify).
- Identify the ordering physician by providing their name. Additionally, include any other individuals who should receive a report, such as a genetic counselor or a send-out lab. For each recipient, fill in their name, address, phone number, fax number, and email.
- Move on to the billing information section. Note that third-party billing is not accepted. Choose either institutional billing or patient billing. If selecting institutional billing, provide the billing contact’s name and email. For credit card payments, fill in the cardholder's name, credit card number, expiration date, and billing address. Also provide the amount to be charged and obtain the required signature from the cardholder.
- In the clinical information section, provide a brief description relevant for interpretation purposes. If there are prior genetic testing results, attach them for consideration. Also, provide information about family history if a familial mutation is known, and include pedigrees if available.
- Select the appropriate testing requested from the options available, such as renal disease, BAF-related disorders, or leukodystrophies. Ensure all necessary checkboxes are marked and additional information is attached if required.
- Once all sections are complete, review the form for accuracy. Save changes, and consider downloading, printing, or sharing the completed form as necessary.
Complete your Nemours Next Generation Sequencing Panel Sample Submission form online today.
To send a sample for Nemours Next Generation Sequencing (NGS) Panel Sample Submission, package your sample securely in a leak-proof container. Ensure you provide all necessary documentation, including a submission form with details about your sample. Proper labeling and documentation help streamline the process upon arrival. For specific instructions, check our user-friendly platform.