It may be helpful for the clinician to phone or contact us to discuss the patient with the genetic counselor, Dru Leistritz (206-543-5464 and email@example.com), to determine if testing is appropriate and which test to select. After selecting the test, please follow these steps to order it:
1) COMPLETE REQUIRED FORMS
For Exome Sequencing and Genome sequencing use the EXOME AND GENOME TEST REQUISITION FORM. Please note that proband consent forms are included after the requisition form. Comparator consent forms should be downloaded and completed separately.
For Exome Panels (Movement Disorders, Cardiac Arrhythmia, Cardiomyopathy, Retinal Dystrophy), Targeted/Familial Variant Testing, or Exome Panel on Demand testing use the EXOME PANEL TEST REQUISITION FORM
For Neurology Test Panels (Movement Disorders, Neurodegenerative Disorders, Neuromuscular Disorders) use the NEUROLOGY TEST REQUISITION FORM
3) COLLECT SPECIMEN
BLOOD is the Preferred Specimen drawn in a lavender top tube (EDTA):
You may submit DNA (5ug at >20ng/uL) or saliva (Oragene kit acceptable) if necessary. Please note that genomic DNA is accepted only from CLIA-certified laboratories or laboratories meeting equivalent requirements. If there are difficulties with arranging for laboratory blood draw and shipment, please contact the laboratory for more details and blood tube or saliva kits.
Specimen Identification: Please label the sample tubes with two identifiers: 1) the patient’s full name and 2) date of birth. Confirm that these identifiers match the information on the test requisition form. When possible, please include the patient’s medical record number. Samples received without the required two identifiers cannot be used. For genomic DNA samples, please include volume and concentration.
4) SHIP SPECIMEN AND FORMS TO NCGL:
Laboratory for Precision Diagnostics
Northwest Clinical Genomics Laboratory
1959 NE Pacific St., HSC H-561
Seattle, WA 98195
Phone: 206.543.0459; FAX: 206.616.1899 email: firstname.lastname@example.org
5) Receive Results
Results will be faxed to you at the contact points you provided on the requisition form.
Policy for ordering additional testing (“add-on” testing):
An “Add-on Test” is a request to add an additional test to a previously tested patient specimen. Add-on tests may be requested for all specimen types, including prenatal specimens. For older tests, please contact the laboratory to confirm there is a sufficient amount of DNA prior to ordering new testing.
To order an add-on test, please complete a new test requisition form appropriate to the test (see FORMS), including payment information. Under “Sample Information”, “Other” write in “Add-on testing, stored sample”. Fax the completed requisition to (206) 616-1899. In some cases a new sample may be required to perform the test, in which case the ordering laboratory/physician will be notified as soon as possible.
Policy for revising or cancelling a test:
To cancel or revise a test, please contact the laboratory in writing within 24 hours of receipt of sample, either by email (email@example.com) or by faxing a letter with the test revision or cancellation request to fax number (206) 616-1899. Orders cancelled more than 24 hours after receipt may incur a prorated charge based on the work that has been completed as of the time of cancellation. There is no charge to revise or cancel a test that has not been started (for example, is still in insurance pre-authorization); please call (206) 543-0459 for more information.